• Drug discovery today · Sep 2014

    Review Comparative Study

    Reversal of target-specific oral anticoagulants.

    • Deborah M Siegal and Adam Cuker.
    • Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, ON, Canada.
    • Drug Discov. Today. 2014 Sep 1; 19 (9): 1465-70.

    AbstractTarget-specific oral anticoagulants (TSOACs) provide safe and effective anticoagulation for the prevention and treatment of thrombosis in a variety of clinical settings by interfering with the activity of thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban, edoxaban, betrixaban). Although TSOACs have practical advantages over vitamin K antagonists (VKAs), there are currently no antidotes to reverse their anticoagulant effect. Herein we summarize the available evidence for TSOAC reversal using nonspecific and specific reversal agents. We discuss important limitations of existing evidence, which is derived from studies in human volunteers, animal models and in vitro experiments. Studies evaluating the safety and efficacy of reversal agents on clinical outcomes such as bleeding and mortality in patients with TSOAC-associated bleeding are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

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