Andexanet alfa versus four-factor prothrombin complex concentrate for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage: a propensity score-overlap weighted analysis.

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Abstract

Andexanet alfa is approved (FDA "accelerated approval"; EMA "conditional approval") as the first specific reversal agent for factor Xa (FXa) inhibitor-associated uncontrolled or life-threatening bleeding. Four-factor prothrombin complex concentrates (4F-PCC) are commonly used as an off-label, non-specific, factor replacement approach to manage FXa inhibitor-associated life-threatening bleeding. We evaluated the effectiveness and safety of andexanet alfa versus 4F-PCC for management of apixaban- or rivaroxaban-associated intracranial hemorrhage (ICH).

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Journal ID (iso-abbrev): Crit Care

Title: Critical care (London, England)

Publisher: Springer Science and Business Media LLC

ISSN (Electronic): 1466-609X

ISSN (Print): 1364-8535

Publication date (Electronic): Jun 16 2022

Volume: 26

Issue: 1

Affiliations

[1 ] Department of Pharmacy Practice, University of Connecticut School of Pharmacy, 69 North Eagleville Road, Unit 3092, Storrs, CT, 06269, USA.

[2 ] Evidence-Based Practice Center, Hartford Hospital, Hartford, CT, USA.

[3 ] Department of Medicine, McMaster University, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada.

[4 ] Population Health Research Institute, Hamilton, ON, Canada.

[5 ] Thrombosis and Anticoagulation Service, Division Hematology and Hemostaseology, Department of Medicine I, Dresden University Hospital, Fetscherstrasse 74, 01307, Dresden, Germany.

[6 ] Department of Global Health Economics and Outcomes Research, Alexion, AstraZeneca Rare Disease, 121 Seaport Blvd, Boston, MA, 02210, USA.

[7 ] Department of Pharmacy Practice, University of Connecticut School of Pharmacy, 69 North Eagleville Road, Unit 3092, Storrs, CT, 06269, USA. craig.coleman@hhchealth.org.

[8 ] Evidence-Based Practice Center, Hartford Hospital, Hartford, CT, USA. craig.coleman@hhchealth.org.

Article

Publisher Item ID: 10.1186/s13054-022-04043-8

DOI: 10.1186/s13054-022-04043-8

PMC ID: 9204964

PubMed ID: 35710578

SO-VID: fd0b9236-97af-45c5-8731-e146b1f85111

History

Keywords: Direct factor Xa inhibitor reversal,Intracranial hemorrhage,Four-factor prothrombin complex concentrate,Andexanet alfa

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Keywords: Direct factor Xa inhibitor reversal, Intracranial hemorrhage, Four-factor prothrombin complex concentrate, Andexanet alfa

Andexanet alfa versus four-factor prothrombin complex concentrate for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage: a propensity score-overlap weighted analysis.

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