Treatment of emergencies associated with bleeding risk in patients taking new oral anticoagulants - options concerning termination of their effect
Abstract
New oral anticoagulants prescribed in the Czech Republic (dabigatran, apixaban, rivaroxaban), indicated for prevention of systemic embolization in non valvular atrial fibrillation and for treatment of thromboembolic disease, had a major disadvantage until recently: there was no specific antidote available for their users in cases of significant bleeding or in cases when urgent surgery was needed. During autumn of 2015, antidote for dabigatran exetilate - idarucizumab, a monoclonal antibody capable of binding and inactivation of this drug - was approved for clinical use.
It has been registered and became available on the pharmaceutical market. As for the xabans, two antidotes are approaching their approval - andexanet alpha, making its way through phase 3 clinical trials (xaban antidote), and ciraparantag (PER77), acting as a universal antidote of both xabans and heparins.