Using Andexanet Alfa as an Antidote to Manage Intracranial Hemorrhage Caused by Factor Xa Inhibitors
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on June 3rd, 2024
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To prevent thrombosis, factor Xa inhibitors are usually used. However, the anticoagulant increases the risk of hemorrhage. To prevent this unwanted effect, antagonists for the inhibitor can potentially be used as an antidote. Andexanet alfa is an inactive form of factor Xa that can bind to and neutralize the anticoagulant. A study was conducted to assess the effectiveness of andexanet alfa in preventing mortality and reducing morbidity associated with intracerebral caused by factor Xa inhibitors.
The study included 452 patients with intracranial hemorrhage who had used a factor Xa inhibitor within the previous 15 hours. 60% of the patients were treated with apixaban, 30% with rivaroxaban, and 10% with edoxaban. At baseline, CT and MRI scan determine the median hematoma volume was around 10 mL, and the cohort’s average systolic blood pressure was around 160 mmHg. In addition, almost 90% of the patients had a history of atrial fibrillation, 20% of stroke, and 10% of myocardial infarction and deep vein thrombosis. Half of the patients were randomly assigned to be treated with andexanet alfa, and the other was treated with the standard care of prothrombin complex concentrate. By the end of the study, the researchers concluded that the usage of andexanet alfa significantly reduced the rate of hematoma formation and the risk of thrombotic event.
The study included 452 patients with intracranial hemorrhage who had used a factor Xa inhibitor within the previous 15 hours. 60% of the patients were treated with apixaban, 30% with rivaroxaban, and 10% with edoxaban. At baseline, CT and MRI scan determine the median hematoma volume was around 10 mL, and the cohort’s average systolic blood pressure was around 160 mmHg. In addition, almost 90% of the patients had a history of atrial fibrillation, 20% of stroke, and 10% of myocardial infarction and deep vein thrombosis. Half of the patients were randomly assigned to be treated with andexanet alfa, and the other was treated with the standard care of prothrombin complex concentrate. By the end of the study, the researchers concluded that the usage of andexanet alfa significantly reduced the rate of hematoma formation and the risk of thrombotic event.