title: Idarucizumab, a Humanized, Monoclonal  Antibody Fragment for Immediate Reversal  of Dabigatran.
abstract: OBJECTIVE
  To evaluate the role of idarucizumab, a humanized monoclonal antibody fragment, as a specific reversal agent for the anticoagulant activity of dabigatran and to review the pharmacology, pharmacokinetic properties, efficacy, and safety of this agent.
  
  
  METHODS
  A literature search was conducted consisting of a PubMed database using the MeSH term idarucizumab and the key word dabigatran antidote. Studies evaluating the pharmacology, pharmacokinetics, safety, and efficacy of idarucizumab for the reversal of the anticoagulant activity of dabigatran were included.
  
  
  RESULTS
  Idarucizumab represents a novel treatment option as it is the only humanized, monoclonal antibody fragment that specifically binds to dabigatran. Studies evaluating reversal of dabigatran-induced anticoagulation have demonstrated immediate, complete, and sustained effects with idarucizumab. Idarucizumab did not overcorrect thrombin generation. Additionally, evaluations have shown that dabigatran can be safely reinitiated 24 hours after the administration of idarucizumab. The United States Food and Drug Administration granted priority review for the biologic license application and accelerated approval for idarucizumab.
  
  
  CONCLUSIONS
  Idarucizumab represents an encouraging development in the reversal of dabigatran. Its novel mechanism of action, pharmacokinetics, tolerability, and lack of thrombotic events contribute positively to its use in patients who experience bleeding or for those who require emergent surgery or procedures.
authors.forename: Marta A
authors.initials: MA
authors.lastname: Miyares
authors.forename: Yara
authors.initials: Y
authors.lastname: Kuyumjian
authors.forename: Shannon
authors.initials: S
authors.lastname: Eaves
authors.forename: Eliza
authors.initials: E
authors.lastname: Dollard
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000925:Anticoagulants / Q000009:adverse effects; D000069604:Dabigatran / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000925:Anticoagulants; C000594745:idarucizumab; D000069604:Dabigatran