In vitro reversal of direct factor Xa inhibitors: Direct comparison of andexanet alfa and prothrombin complex concentrates Cofact and Beriplex/Kcentra.

ABSTRACT:

Background

Both andexanet alfa and four-factor prothrombin complex concentrate (4F-PCC) are clinically applied reversal agents for direct factor Xa inhibitors (FXaIs) in emergency situations. Controversy exists whether 4F-PCC is as effective as andexanet alfa in correcting FXaI anticoagulation.

Objective

This in vitro study was designed to directly compare andexanet alfa with two different 4F-PCCs (Cofact and Beriplex/Kcentra) in their ability to correct FXaI anticoagulation.

Method

Normal plasma was spiked with apixaban or rivaroxaban. Reversal of anticoagulation was assessed using a thrombin generation assay and a fibrin generation-clot lysis test.

Results

Andexanet alfa, applied at clinically recommended doses, was effective in restoring thrombin generation

SUBMITTER: Brinkman HJM 

PROVIDER: S-EPMC9343596 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature