A drug that reverses the blood thinning effects of factor Xa
inhibitors effectively stopped acute life-threatening bleeding in patients
taking a factor Xa inhibitor blood thinner drug, according to late breaking
science presented at the American Stroke Association’s International Stroke
Conference 2019 currently being held in Honolulu.
The study will be simultaneously published in the New England Journal of Medicine.
Factor Xa inhibitor blood thinners (apixaban,
rivaroxaban, or edoxaban, which are direct factor Xa inhibitors) and enoxaparin
are used to prevent blood clots but can also cause or worsen serious bleeding.
The agent andexanet alfa is designed to rapidly neutralise the anticoagulant
effects of blood thinners in the event of acute bleeding. Researchers
investigated if andexanet alfa could decrease the effect of the blood thinner
and decrease bleeding assessed 12 hours after administering the reversal agent.
A total of 352 patients (average age 77, 53%) were enrolled
from 86 sites worldwide, after presenting to emergency rooms with primarily
gastrointestinal bleeding or brain bleeding. Researchers said good or excellent
hemostasis (the stopping of bleeding) occurred in 81.7% of patients.
“The study supported the May 2018 FDA approval of andexanet
alfa, now the only approved agent for patients taking rivaroxaban and apixaban
when urgent reversal is needed for life-threatening or uncontrolled bleeding,
said senior author Truman J. Milling Jr., MD, associate professor, Department
of Neurology and associate professor, Department of Surgery and Perioperative
Care at Seton Dell Medical School Stroke Institute in Austin, Texas.
SJ, et al. Full Study Report of Andexanet Alfa for Bleeding Associated with
Factor Xa Inhibitors. NEJM. Published 7 February 2019. https://www.nejm.org/doi/full/10.1056/NEJMoa1814051?query=featured_home