Titre
Recommendations for the use of andexanet alfa in the management of bleeding in patients on oral factor Xa inhibitors in Switzerland: Guideline from the Working Party Hemostasis of the Swiss Society of Hematology.
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Angelillo-Scherrer, A.
Auteure/Auteur
Casini, A.
Auteure/Auteur
Studt, J.D.
Auteure/Auteur
Gerber, B.
Auteure/Auteur
Alberio, L.A.
Auteure/Auteur
Fontana, P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-3997
Statut éditorial
Publié
Date de publication
2023-07-26
Volume
153
Première page
40113
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Anticoagulants are essential in preventing and treating thrombosis. Unfortunately, their use is accompanied by an enhanced risk of bleeding. Since the introduction of direct oral anticoagulants (DOACs), the risk of major bleeding has been reduced but not eliminated. Major bleeding events related to the use of factor Xa inhibitors can be challenging to manage. In recent years, four-factor prothrombin complex concentrates have been used in patients with severe bleeding taking oral direct factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). Andexanet alfa (OndexxyaTM, AstraZeneca AG) is a specially designed recombinant version of human factor Xa that acts as a decoy receptor to reverse the effects of factor Xa inhibitors. Since 2 December 2020, andexanet alfa has been used in Switzerland for adult patients receiving apixaban or rivaroxaban when reversal of anticoagulation is required because of life-threatening or uncontrolled bleeding. However, the use of andexanet alfa remains a challenge owing to its cost, the reported thrombotic complications and the fact that its efficacy mainly relates to intracranial haemorrhage. Moreover, the use of nonspecific reversal agents together with andexanet alfa is controversial. The present recommendations on the use of andexanet alfa in the management of bleeding in patients on factor Xa inhibitors in Switzerland were developed by a group of Swiss experts from the Working Party Hemostasis of the Swiss Society of Hematology. These recommendations aim to provide support to clinicians in their decision-making in the management of patients with major bleeding receiving factor Xa inhibitors.
PID Serval
serval:BIB_DAEA41D37FD0
PMID
Open Access
Oui
Date de création
2023-07-31T12:37:07.107Z
Date de création dans IRIS
2025-05-21T05:29:47Z
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Nom
37499160.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
716.6 KB
Format
Adobe PDF
PID Serval
serval:BIB_DAEA41D37FD0.P001
URN
urn:nbn:ch:serval-BIB_DAEA41D37FD00
Somme de contrôle
(MD5):5c78ce7c59e3b7b4140b13287fda5fa3