title: Reversal of novel oral anticoagulants.
abstract: The development of a new generation of non-vitamin K oral anticoagulants represents a potential breakthrough in the management of patients with thrombotic diseases, disorders and conditions. While a large and growing body of evidence from large-scale clinical trials and registries supports a favorable safety profile, having a means to rapidly reverse their anticoagulant effects represents an unmet need among practicing clinicians. Several targeted reversal agents are currently in development and the early results are promising. Idarucizumab is a monoclonal antibody that can immediately and specifically reverse dabigatran. Andexanet alfa is a recombinant modified factor Xa that can bind and reverse oral and parenteral factor Xa inhibitors, including rivaroxaban, apixaban and edoxaban, and low molecular weight heparin. Aripazine is a small molecule that can reverse the action of factor Xa inhibitors and possibly dabigatran as well through non-covalent binding and charge-charge interactions.
authors.affiliation: Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Heart, Lung and Vascular Institute, Cincinnati, OH, USA.
authors.forename: Elsayed
authors.initials: E
authors.lastname: Abo-Salem
authors.affiliation: Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Heart, Lung and Vascular Institute, Cincinnati, OH, USA. Electronic address: Beckerrc@ucmail.uc.edu.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Becker
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use*; D015951:Factor Xa / Q000378:metabolism; D065427:Factor Xa Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D013927:Thrombosis / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D015951:Factor Xa