Key result
Andexanet alfa partially neutralized unfractionated heparin and low molecular weight heparin but was less effective than protamine sulfate (tested at 10 ug/mL) across multiple coagulation assays.
Why the study?
Due to protamine sulfate shortages, this study investigated whether andexanet alfa could neutralize unfractionated heparin and low molecular weight heparin across ACT, TEG, and anti-Xa assays.
Does andexanet alfa neutralize unfractionated heparin and low molecular weight heparin in vitro compared to protamine sulfate?
Does andexanet alfa neutralize unfractionated heparin and low molecular weight heparin in vitro compared to protamine sulfate?
Andexanet alfa partially neutralizes UFH and LMWH in vitro but is less effective than protamine sulfate, indicating it may not be a suitable alternative for heparin reversal.
No takes yet. Share an insight, caveat, or question.
Protamine remains preferred for heparin reversal; these in vitro data leave open any clinical role for andexanet alfa.
Lewis et al. (2022) studied Anticoagulation reversal. Andexanet alfa vs. Protamine sulfate or saline was evaluated on Neutralization of UFH and LMWH in ACT, TEG, and anti-Xa assays. Andexanet alfa partially neutralized unfractionated heparin and low molecular weight heparin but was less effective than protamine sulfate (tested at 10 ug/mL) across multiple coagulation assays.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: