Why the study?
The increasing need for oral anticoagulation and limitations of vitamin K antagonists motivate evaluation of reversal strategies for next-generation anticoagulants like milvexian.
May support aPCC or rFVIIa as potential milvexian reversal agents; leaves open clinical validation in patients.
The need for oral anticoagulation is rising to combat an increasing prevalence of atrial fibrillation and venous thromboembolism in an aging global population. For more than 65 years, only one class of oral anticoagulants filled this role: vitamin K antagonists, which include warfarin and other coumarin derivatives. However, such drugs require monitoring of the international normalized ratio and subsequent dose adjustment owing to their slow onset and offset and unpredictable pharmacokinetics, along with dietary intake of vitamin K, coexisting illnesses, or other medications. These agents are highly effective in reducing thromboembolic complications (including stroke in patients with atrial fibrillation), but . . .
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Hunt et al. (2016) studied Healthy volunteers (in vitro milvexian reversal) (n=6). aPCC and rFVIIa vs. Milvexian alone (vehicle control) was evaluated on Correction of milvexian-induced prolongation of activated partial thromboplastin time (aPTT) expressed as fold-change above baseline.
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