Direct oral anticoagulants: first airbag
The safety profile of oral anticoagulants (DOACs) was confirmed in the large-scale studies, the increased risk of hemorrhagic events does still exist, which may be caused by the nature of the patient’s concomitant pathology, the resulting injury or the need for emergency surgical procedures. Such me...
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Format: | Article |
Language: | Russian |
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Remedium Group LLC
2019-04-01
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Series: | Медицинский совет |
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Online Access: | https://www.med-sovet.pro/jour/article/view/2908 |
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author | A. N. Sokolova A. I. Skripka |
author_facet | A. N. Sokolova A. I. Skripka |
author_sort | A. N. Sokolova |
collection | DOAJ |
description | The safety profile of oral anticoagulants (DOACs) was confirmed in the large-scale studies, the increased risk of hemorrhagic events does still exist, which may be caused by the nature of the patient’s concomitant pathology, the resulting injury or the need for emergency surgical procedures. Such measures to restore the coagulation cascade as the use of prothrombin complex concentrates or hemodialysis have not been widely used in the clinical practice to stop the anti-coagulant effect of DOACs and do not have an evidence base. Today, idarutsizumab (Praxbind) is the only specific antagonist to DOACs registered in the Russian Federation, a neutralizing agent that interacts with free and thrombin-related dabigatran, without affecting other blood coagulation factors and platelet function. RE-VERSE AD study showed that administration of idarucizumab in patients receiving dabigatran therapy and who developed life-threatening bleeding provided complete neutralization of the anti-coagulant effect of dabigatran for 4 hours, and after 1.5 hours emergency surgical treatment was performed, achieving at the same time, normal perioperative hemostasis in 93.4% of cases. The availability of a specific neutralizing agent for a specific DOAC could be identified as arguments in favour of choosing this drug for patients who have a high risk of a hemorrhagic event, emergency surgery or thrombolysis. |
first_indexed | 2024-04-09T16:42:08Z |
format | Article |
id | doaj.art-37700b374c6144b1a9eee9546b2d0c9b |
institution | Directory Open Access Journal |
issn | 2079-701X 2658-5790 |
language | Russian |
last_indexed | 2024-04-09T16:42:08Z |
publishDate | 2019-04-01 |
publisher | Remedium Group LLC |
record_format | Article |
series | Медицинский совет |
spelling | doaj.art-37700b374c6144b1a9eee9546b2d0c9b2023-04-23T06:56:39ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902019-04-010561210.21518/2079-701X-2019-5-6-122829Direct oral anticoagulants: first airbagA. N. Sokolova0A. I. Skripka1Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University.Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University.The safety profile of oral anticoagulants (DOACs) was confirmed in the large-scale studies, the increased risk of hemorrhagic events does still exist, which may be caused by the nature of the patient’s concomitant pathology, the resulting injury or the need for emergency surgical procedures. Such measures to restore the coagulation cascade as the use of prothrombin complex concentrates or hemodialysis have not been widely used in the clinical practice to stop the anti-coagulant effect of DOACs and do not have an evidence base. Today, idarutsizumab (Praxbind) is the only specific antagonist to DOACs registered in the Russian Federation, a neutralizing agent that interacts with free and thrombin-related dabigatran, without affecting other blood coagulation factors and platelet function. RE-VERSE AD study showed that administration of idarucizumab in patients receiving dabigatran therapy and who developed life-threatening bleeding provided complete neutralization of the anti-coagulant effect of dabigatran for 4 hours, and after 1.5 hours emergency surgical treatment was performed, achieving at the same time, normal perioperative hemostasis in 93.4% of cases. The availability of a specific neutralizing agent for a specific DOAC could be identified as arguments in favour of choosing this drug for patients who have a high risk of a hemorrhagic event, emergency surgery or thrombolysis.https://www.med-sovet.pro/jour/article/view/2908atrial fibrillationanticoagulant therapydirect oral anticoagulantsneutralizing agentdabigatranidarucizumabthromboembolic complicationshemorrhagic complications |
spellingShingle | A. N. Sokolova A. I. Skripka Direct oral anticoagulants: first airbag Медицинский совет atrial fibrillation anticoagulant therapy direct oral anticoagulants neutralizing agent dabigatran idarucizumab thromboembolic complications hemorrhagic complications |
title | Direct oral anticoagulants: first airbag |
title_full | Direct oral anticoagulants: first airbag |
title_fullStr | Direct oral anticoagulants: first airbag |
title_full_unstemmed | Direct oral anticoagulants: first airbag |
title_short | Direct oral anticoagulants: first airbag |
title_sort | direct oral anticoagulants first airbag |
topic | atrial fibrillation anticoagulant therapy direct oral anticoagulants neutralizing agent dabigatran idarucizumab thromboembolic complications hemorrhagic complications |
url | https://www.med-sovet.pro/jour/article/view/2908 |
work_keys_str_mv | AT ansokolova directoralanticoagulantsfirstairbag AT aiskripka directoralanticoagulantsfirstairbag |