Detalle Publicación

When and how to use reversal agents for direct oral anticoagulants?

Autores: Gómez-Outes, A. (Autor de correspondencia); Suárez-Gea, M. L.; Lecumberri Villamediana, Ramón
ISSN: 1523-3782
Volumen: 25
Número: 5
Páginas: 371 - 380
Fecha de publicación: 2023
Purpose of ReviewOur objective is to describe currently available reversal agents for direct oral anticoagulants (DOACs), their target population, the available clinical practice recommendations and future directions.Recent FindingsSpecific (idarucizumab for dabigatran and andexanet alfa for direct factor Xa inhibitors) and non-specific (prothrombin complex concentrates) reversal agents are effective in neutralizing the anticoagulant effect of DOACs. New investigational antidotes such as ciraparantag and VMX-C001 offer an alternative to andexanet alfa in reversing the anticoagulant activity of direct oral factor Xa inhibitors, but more clinical data are needed before they could be licensed for use.Specific reversal agents are recommended for use in clinical situations within their licensed indications (i.e.: reversal of DOACs in patients with severe uncontrolled or life-threatening bleeding or in need of emergency surgery or other invasive procedures), while non-specific reversal agents may be used when specific antidotes are not available or indicated.