April 10, 2021Annals of Pharmacotherapy

Factor VIII Inhibitor Bypassing Activity (FEIBA) Reversal for Apixaban and Rivaroxaban in Patients With Acute Intracranial and Nonintracranial Hemorrhage

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Why the study?

Clinical use of FEIBA for factor Xa inhibitor reversal is derived from small, variable studies, warranting additional effectiveness and safety data.

Does FEIBA provide effective hemostasis and acceptable safety in patients with acute hemorrhage on apixaban or rivaroxaban?

Population

104 patients receiving FEIBA for apixaban or rivaroxaban reversal secondary to acute ICH or non-ICH

Comparison

Apixaban vs rivaroxaban reversal across ICH and non-ICH populations

Design

Retrospective case series

Follow-up

30-day post-discharge

Authors

AHAleah R. HuntSpectrum Health SCShawn N. CoffeenMontgomery General Hospital DSDane L. ShiltzFerris State University

Discussion

Member takes

Implication

May support hemostasis in most apixaban/rivaroxaban bleeds; hypothesis-generating case data leave efficacy unconfirmed.

Structured PICO

Does FEIBA provide effective hemostasis and acceptable safety in patients with acute hemorrhage on apixaban or rivaroxaban?

Population

104 patients who received at least one FEIBA dose for apixaban (n=62) or rivaroxaban (n=42) reversal secondary to acute intracranial hemorrhage (ICH, n=55) or non-ICH (n=49)

Intervention

Factor VIII Inhibitor Bypassing Activity (FEIBA) administration for apixaban or rivaroxaban reversal

Comparator

Apixaban users vs. Rivaroxaban users

Outcome

Incidence of observed effective hemostasis within 24 hours post-FEIBA administrationhard clinical

FEIBA administration for apixaban or rivaroxaban reversal in acute hemorrhage resulted in 89% effective hemostasis, with comparable outcomes between the two FXa inhibitors.

Limitations

Retrospective study design
Lack of an active comparator

Cite This Study

Hunt et al. (2021) studied this question.

synapsesocial.com/papers/6a892cf23981116ebf4d3467 https://doi.org/10.1177/10600280211004583

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Factor VIII Inhibitor Bypassing Activity (FEIBA) Reversal for Apixaban and Rivaroxaban in Patients With Acute Intracranial and Nonintracranial Hemorrhage

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Factor VIII Inhibitor Bypassing Activity (FEIBA) Reversal for Apixaban and Rivaroxaban in Patients With Acute Intracranial and Nonintracranial Hemorrhage

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider