title: Non-vitamin K antagonist oral anticoagulant reversal: hope is on the horizon.
abstract: BACKGROUND
  Non-vitamin K oral anticoagulants have become an attractive alternative to warfarin when patients require anticoagulation. Until recently, one of the biggest challenges to these agents was the lack of specific reversal of their anticoagulation when bleeding occurs or urgent/emergent procedures are required.
  
  
  METHODS
  This article is a narrative review of peer-reviewed publications with particular attention to authors that are experts in the field, society guidelines, and government publications.
  
  
  CONCLUSIONS
  Development of several drugs has led to agent-specific reversal. Idarucizumab has gained approval in the United States for reversal of dabigatran. Andexanet alfa has completed promising phase III trials for the reversal of factor Xa inhibitors. Aripazine (PER977) has shown promise as a universal reversal agent against non-vitamin K antagonist oral anticoagulants and heparin products.
authors.affiliation: Division of Trauma, Burns, and Surgical Critical Care, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: Byorkgitis@partners.org.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Yorkgitis
mesh_terms: D000284:Administration, Oral; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000494:pharmacology; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D000069604:Dabigatran / Q000008:administration & dosage* / Q000009:adverse effects; D065427:Factor Xa Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000925:Anticoagulants; D065427:Factor Xa Inhibitors; C000594745:idarucizumab; D000069604:Dabigatran
keywords: Andexanet alfa; Anticoagulants; Aripazine; Ciraparantag; Idarucizumab