Key result
Prothrombinase complex concentrate (activated or inactivated) appears to be the most effective option for reversing the effects of new oral anticoagulants based on hemostatic tests, though clinical efficacy data in bleeding patients is lacking.
Why the study?
Do reversal agents such as PCC and rFVIIa reverse the anticoagulant effects and improve hemostatic parameters in models of new oral anticoagulant use?
Population
23 studies evaluating reversal strategies for new oral anticoagulants.
Comparison
Reversal agents including prothrombinase complex… vs Placebo, no reversal agent, or alternative…
Design
Systematic_review
Authors
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May guide PCC use for NOAC reversal on hemostatic tests alone; leaves open need for clinical outcome trials in bleeding patients.
Systematic Review (n=23)
Do reversal agents such as PCC and rFVIIa reverse the anticoagulant effects and improve hemostatic parameters in models of new oral anticoagulant use?
The best available evidence suggests that PCC may be the most effective currently available option for reversing new oral anticoagulants, particularly rivaroxaban, though clinical efficacy data in bleeding patients is urgently needed.
Lazo‐Langner et al. (2013) conducted a systematic review in Bleeding associated with new oral anticoagulants (n=23). Prothrombinase complex concentrate (PCC) and recombinant activated factor VII (rFVIIa) was evaluated on Reversal of anticoagulant effects assessed by hemostatic tests or bleeding models. Prothrombinase complex concentrate (activated or inactivated) appears to be the most effective option for reversing the effects of new oral anticoagulants based on hemostatic tests, though clinical efficacy data in bleeding patients is lacking.
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