Premium
Recent Advances in the Development of Specific Antidotes for Target‐Specific Oral Anticoagulants
Author(s) -
Mo Yoonsun,
Yam Felix K.
Publication year - 2015
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1532
Subject(s) - medicine , warfarin , intensive care medicine , vitamin k antagonist , clinical trial , pharmacodynamics , idarucizumab , food and drug administration , drug , anticoagulant , narrative review , dabigatran , pharmacokinetics , pharmacology , atrial fibrillation , surgery
Warfarin, a vitamin K antagonist, has been the only orally available anticoagulant for > 60 years. During the past decade, the U.S. Food and Drug Administration has approved several target‐specific oral anticoagulants ( TSOAC s) for the prophylaxis and treatment of arterial and venous thromboembolism and stroke prevention in patients with nonvalvular atrial fibrillation. These new agents have several advantages over warfarin including more predictable pharmacokinetics and pharmacodynamics, fewer food and drug interactions, and lack of need for routine coagulation monitoring. However, unlike warfarin, currently no antidotes are available to reverse the anticoagulant effect of TSOAC s. Specific antidotes for TSOAC s may not be needed in most situations due to their short half‐life, yet the absence of antidotes for these agents is a concern, especially in emergent situations such as life‐threatening major bleeding or nonelective major surgery. Several specific antidotes for TSOAC s including idarucizumab, andexanet alfa, and aripazine have been developed and have shown promise in early clinical trials evaluating their efficacy and safety. In this narrative review, the progress made in developing specific antidotes for TSOAC s is summarized based on the latest available preclinical and clinical data.