AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca 
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  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Clinical, Review, Journal:  Recanalisation therapies for acute ischaemic stroke in patients on direct oral anticoagulants. (Pubmed Central) -  Jan 4, 2022   
    In patients on DOAC therapy with large vessel occlusion, decision for intravenous thrombolysis should not delay thrombectomy (eg, direct thrombectomy or immediate transfer to a thrombectomy-capable centre recommended). Precision medicine using a tailored approach combining clinicoradiological information (ie, penumbra and vessel status), anticoagulant activity and use of specific reversal agents only if necessary seems a reasonable choice.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Journal:  Evidence for Andexanet Alpha in Reversing Intracerebral Hemorrhage due to Factor Xa Inhibitors? (Pubmed Central) -  Dec 25, 2021   
    Precision medicine using a tailored approach combining clinicoradiological information (ie, penumbra and vessel status), anticoagulant activity and use of specific reversal agents only if necessary seems a reasonable choice. No abstract available
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    NEW THROMBUS FORMATION IMMEDIATELY AFTER ANDEXANET ALFA INFUSION: A CASE REPORT AND LITERATURE REVIEW. (Chapman #4 (Sunset Center)) -  Dec 20, 2021 - Abstract #WSMRF2022WSMRF_176;    
    Interestingly, no thrombotic events were reported in ANNEXA-4 patients who restarted anticoagulation protocols. Thus, it may be advisable to monitor patients closely and broadly for thrombotic events until future studies update protocols for resuming anticoagulation therapy after reversal treatment.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Preclinical, Journal:  Investigation of the Optimal Dose aPCC in Reversing the Effect of Factor Xa Inhibitors-An In Vitro Study. (Pubmed Central) -  Dec 16, 2021   
    There are concerns about the lack of a reversal strategy in case of serious bleeds or need for emergency surgery in situations when the antidote andexanet alfa is not available...To determine the lowest concentration of aPCC sufficient to reverse the effect of rivaroxaban and apixaban...Concentrations of 0.56 U/mL and higher, caused significantly higher ETP than baseline in apixaban-containing samples (P < 0.05). aPCC concentrations lower than previously reported were effective in reversing the effect of FXa inhibitors in vitro.
  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Clinical, Review, Journal:  Emergency cardiac surgery in patients on oral anticoagulants and antiplatelet medications. (Pubmed Central) -  Dec 16, 2021   
    Four-factor prothrombin complex concentrate is considered in patients on oral anticoagulants if CPB needs to be instituted quickly. Specific reversal agents such as idarucizumab and andexanet alfa can be considered if significant tissue dissection is anticipated, such as redo sternotomy, but are costly and may lead to heparin resistance and anticoagulant rebound.
  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Review, Journal:  Anticoagulant Reversal in Gastrointestinal Bleeding: Review of Treatment Guidelines. (Pubmed Central) -  Dec 1, 2021   
    Comparative clinical trials are needed. The utility of anticoagulant reversal agents in GI bleeding is recognized in guidelines; however, such agents should be reserved for use in truly life-threatening scenarios.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Enrollment open:  ASTRO-DE: Andexanet Alfa: Non-interventional Study in Stroke Units in Germany (DE) (clinicaltrials.gov) -  Dec 1, 2021   
    P=N/A,  N=140, Recruiting, 
    The utility of anticoagulant reversal agents in GI bleeding is recognized in guidelines; however, such agents should be reserved for use in truly life-threatening scenarios. Not yet recruiting --> Recruiting
  • ||||||||||  Journal:  Reversal of direct oral anticoagulants: Highlights from the Anticoagulation Forum guideline. (Pubmed Central) -  Nov 29, 2021   
    The guideline also discusses off-label use of andexanet alfa for bleeding associated with edoxaban and betrixaban and the use of hemostatic agents such as activated prothrombin complex concentrate and 4-factor prothrombin complex concentrate. Lastly, it offers approaches for building and managing stewardship programs at the health system level.
  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Journal:  Preventing and Managing Bleeding With Anticoagulation for Atrial Fibrillation. (Pubmed Central) -  Nov 29, 2021   
    Lastly, it offers approaches for building and managing stewardship programs at the health system level. No abstract available
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Enrollment change:  Trial of Andexanet Alfa in ICrH Patients Receiving an Oral FXa Inhibitor (clinicaltrials.gov) -  Nov 3, 2021   
    P4,  N=1200, Recruiting, 
    Fixed-dose 1500 unit 4F-PCC, administered within one hour, resulted in no hematoma expansion in 74% of ICHs. N=900 --> 1200
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Expert Theater: Alexion: Andexxa () -  Nov 1, 2021 - Abstract #ACEP2021ACEP_184;    
  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Journal:  Treatment of intracerebral hemorrhage: From specific interventions to bundles of care. (Pubmed Central) -  Oct 27, 2021   
    Early prognostication is difficult, and early do-not-resuscitate orders or withdrawal of active care should be used judiciously in the first 24-48 h of care. Implementation of acute ICH care can be challenging, and using a care bundle approach, with regular monitoring of data and improvement of care processes can ensure consistent and optimal care for all patients.
  • ||||||||||  Praxbind (idarucizumab) / Boehringer Ingelheim, AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Clinical, Clinical protocol, Review, Journal:  Clinical protocols for oral anticoagulant reversal during high risk of bleeding for emergency surgical and nonsurgical settings: a narrative review. (Pubmed Central) -  Oct 27, 2021   
    Implementation of acute ICH care can be challenging, and using a care bundle approach, with regular monitoring of data and improvement of care processes can ensure consistent and optimal care for all patients. The present algorithms propose a tool to help health care providers in the best decision making for patients under emergency conditions.
  • ||||||||||  rivaroxaban / Generic mfg., apixaban / Generic mfg.
    Clinical, Journal:  Treatment of adults with intracranial hemorrhage on apixaban or rivaroxaban with prothrombin complex concentrate products. (Pubmed Central) -  Oct 22, 2021   
    Both aPCC and 4F-PCC appear safe and equally associated with hematoma stability in patients taking apixaban or rivaroxaban who present with ICH. Prospective studies are needed to identify a superior reversal agent when comparing andexanet alfa to hospital standard of care (4F-PCC or aPCC) and to further explore the optimal dosing strategy for patients with ICH associated with apixaban or rivaroxaban use.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Journal:  Activated prothrombin complex concentrate for reversal of oral factor Xa inhibitors at a level 1 trauma center. (Pubmed Central) -  Oct 20, 2021   
    Prospective studies are needed to identify a superior reversal agent when comparing andexanet alfa to hospital standard of care (4F-PCC or aPCC) and to further explore the optimal dosing strategy for patients with ICH associated with apixaban or rivaroxaban use. No abstract available
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Trial completion date, Trial primary completion date, Surgery:  Annexa-S: Trial of Andexanet in Patients Receiving an Oral FXa Inhibitor Who Require Urgent Surgery (clinicaltrials.gov) -  Oct 7, 2021   
    P2,  N=100, Recruiting, 
    No abstract available Trial completion date: Apr 2022 --> Oct 2022 | Trial primary completion date: Mar 2022 --> Sep 2022
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Reversal of Factor Xa Inhibitors – It’s a bleeding problem? () -  Oct 1, 2021 - Abstract #EUSEM2021EUSEM_3953;    
    For life threatening bleeding 52% (13/25) correctly suggested using Tranexamic Acid (TXA)...Knowledge of the specific Xa inhibitor reversal agent Andexanet Alfa was limited with 56% (14/25) being aware there was an agent but only 16% (4/25) could attempt to name it...We have since circulated protocols in our weekly Team Brief as well as updating copies of the reversal protocols on our department website. Ongoing education on the topic is necessary to ensure increased knowledge & familiarity with the various therapeutic agents involved in factor Xa reversal.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Reversal of Factor Xa Inhibitors – It’s a bleeding problem? () -  Oct 1, 2021 - Abstract #EUSEM2021EUSEM_3952;    
    For life threatening bleeding 52% (13/25) correctly suggested using Tranexamic Acid (TXA)...Knowledge of the specific Xa inhibitor reversal agent Andexanet Alfa was limited with 56% (14/25) being aware there was an agent but only 16% (4/25) could attempt to name it...We have since circulated protocols in our weekly Team Brief as well as updating copies of the reversal protocols on our department website. Ongoing education on the topic is necessary to ensure increased knowledge & familiarity with the various therapeutic agents involved in factor Xa reversal.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Reversal of Factor Xa Inhibitors – It’s a bleeding problem? () -  Oct 1, 2021 - Abstract #EUSEM2021EUSEM_3951;    
    For life threatening bleeding 52% (13/25) correctly suggested using Tranexamic Acid (TXA)...Knowledge of the specific Xa inhibitor reversal agent Andexanet Alfa was limited with 56% (14/25) being aware there was an agent but only 16% (4/25) could attempt to name it...We have since circulated protocols in our weekly Team Brief as well as updating copies of the reversal protocols on our department website. Ongoing education on the topic is necessary to ensure increased knowledge & familiarity with the various therapeutic agents involved in factor Xa reversal.
  • ||||||||||  AndexXa (coagulation factor Xa (recombinant), inactivated -zhzo) / Daiichi Sankyo, AstraZeneca
    Reversal of Factor Xa Inhibitors – It’s a bleeding problem? () -  Oct 1, 2021 - Abstract #EUSEM2021EUSEM_3950;    
    For life threatening bleeding 52% (13/25) correctly suggested using Tranexamic Acid (TXA)...Knowledge of the specific Xa inhibitor reversal agent Andexanet Alfa was limited with 56% (14/25) being aware there was an agent but only 16% (4/25) could attempt to name it...We have since circulated protocols in our weekly Team Brief as well as updating copies of the reversal protocols on our department website. Ongoing education on the topic is necessary to ensure increased knowledge & familiarity with the various therapeutic agents involved in factor Xa reversal.