Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran

Background and Purpose: Non-vitamin K anticoagulants (NOAC) such as dabigatran have become important therapeutic options for the prevention of stroke. Until recently, there were only nonspecific agents to reverse their anticoagulant effects in a case of emergency. Idarucizumab, an antibody fragment...

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Main Authors: Valentin Held, Philipp Eisele, Christoph C. Eschenfelder, Kristina Szabo
Format: Article
Language:English
Published: Karger Publishers 2016-10-01
Series:Case Reports in Neurology
Subjects:
Online Access:http://www.karger.com/Article/FullText/452096
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author Valentin Held
Philipp Eisele
Christoph C. Eschenfelder
Kristina Szabo
author_facet Valentin Held
Philipp Eisele
Christoph C. Eschenfelder
Kristina Szabo
author_sort Valentin Held
collection DOAJ
description Background and Purpose: Non-vitamin K anticoagulants (NOAC) such as dabigatran have become important therapeutic options for the prevention of stroke. Until recently, there were only nonspecific agents to reverse their anticoagulant effects in a case of emergency. Idarucizumab, an antibody fragment targeting dabigatran, is the first specific antidote for a NOAC to be approved, but real-world experience is limited. Methods: We report two cases of patients on dabigatran with acute intracerebral hemorrhage who received idarucizumab. Results: In both cases, idarucizumab promptly reversed the anticoagulant effect of dabigatran and there was no hematoma expansion in follow-up imaging. Conclusions: In addition to clinical and preclinical studies, our cases add to the experience regarding the safety and efficacy of idarucizumab. They show that idarucizumab may be an important safety option for patients on dabigatran in emergency situations.
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spelling doaj.art-6531e081732f4efbb427188544d66cd82022-12-21T17:45:46ZengKarger PublishersCase Reports in Neurology1662-680X2016-10-018322422810.1159/000452096452096Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with DabigatranValentin HeldPhilipp EiseleChristoph C. EschenfelderKristina SzaboBackground and Purpose: Non-vitamin K anticoagulants (NOAC) such as dabigatran have become important therapeutic options for the prevention of stroke. Until recently, there were only nonspecific agents to reverse their anticoagulant effects in a case of emergency. Idarucizumab, an antibody fragment targeting dabigatran, is the first specific antidote for a NOAC to be approved, but real-world experience is limited. Methods: We report two cases of patients on dabigatran with acute intracerebral hemorrhage who received idarucizumab. Results: In both cases, idarucizumab promptly reversed the anticoagulant effect of dabigatran and there was no hematoma expansion in follow-up imaging. Conclusions: In addition to clinical and preclinical studies, our cases add to the experience regarding the safety and efficacy of idarucizumab. They show that idarucizumab may be an important safety option for patients on dabigatran in emergency situations.http://www.karger.com/Article/FullText/452096Intracerebral hemorrhageAnticoagulantDabigatranIdarucizumabAntidoteStroke
spellingShingle Valentin Held
Philipp Eisele
Christoph C. Eschenfelder
Kristina Szabo
Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
Case Reports in Neurology
Intracerebral hemorrhage
Anticoagulant
Dabigatran
Idarucizumab
Antidote
Stroke
title Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
title_full Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
title_fullStr Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
title_full_unstemmed Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
title_short Idarucizumab as Antidote to Intracerebral Hemorrhage under Treatment with Dabigatran
title_sort idarucizumab as antidote to intracerebral hemorrhage under treatment with dabigatran
topic Intracerebral hemorrhage
Anticoagulant
Dabigatran
Idarucizumab
Antidote
Stroke
url http://www.karger.com/Article/FullText/452096
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AT christophceschenfelder idarucizumabasantidotetointracerebralhemorrhageundertreatmentwithdabigatran
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