About one-third of the patients died by 30 days and about one-quarter had a thromboembolic event. More than 80% of the patients had an indication for reversal that was either an emergent operative procedure, an invasive device placement, or the need for arterial embolization.Ībout 80% of the patients achieved excellent or good hemostasis within 24 hours after periprocedural administration of andexanet alfa, and this rate was similar in the apixaban and rivaroxaban groups. There were numerous secondary outcomes evaluated, including hospital discharge disposition, ICU and hospital length of stay, as well as mortality and ischemic event rates.Ĥ4 patients were analyzed, about two-thirds of which received apixaban and the rest received rivaroxaban. The primary outcome was hemostatic efficacy and grading definitions were similar to those used in the ANNEXA-4 study. Such patients have yet to be represented well in studies of andexanet alfa.Ī group of authors recently published in the journal Pharmacotherapy a single-center, observational, retrospective study looking at patients who received andexanet alfa within 24 hours of an invasive or surgical procedure. However another common indication for immediate reversal of factor Xa inhibitors is the emergent need for surgery or an invasive procedure.
Approval trials like ANNEXA-4 focused on using andexanet alfa to reverse major bleeding associated with factor Xa inhibitors. Subscribe on iTunes, Android, or StitcherĪndexanet alfa is a reversal agent that competitively binds to factor Xa inhibitors such as apixaban and rivaroxaban.
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