AHA 2021: Bentracimab rapid and safe to reverse Ticagrelor's effects, REVERSE IT study.

Bentracimab, an intravenous reversal agent for ticagrelor, has shown immediate and sustained reversal of the Tiacgrelor's antiplatelet effects in both patients undergoing surgery and those with major bleeding, according to a prespecified interim analysis of the REVERSE-IT study presented this week at AHA, 2021.

The drug is a recombinant IgG1 monoclonal antibody fragment that binds to both ticagrelor and its major active circulating metabolite, reversing the antiplatelet effects within 5 minutes. Previous phase I data in healthy participants, published in 2019, sparked excitement as a potential answer to the challenges faced not just by surgeons, but also by physicians when patients on ticagrelor present with an intracranial hemorrhage, for example, and can't wait the recommended 5 days for the drug's effects to wear off.

The goal of the REVERSE IT trial was to assess the safety and efficacy of bentracimab in reversing the antiplatelet effect of ticagrelor among patients needing urgent surgery or a procedure, or with major bleeding.

The inclusion criteria were as follows:

• Last ticagrelor dose within 3 days

• Age ≥18 years

• Patients needing urgent surgery or a procedure (when it is not medically advisable either to proceed urgently with impaired hemostasis or to delay the urgent procedure for 3 or more days as directed by ticagrelor labeling due to the high risk of bleeding) or with major bleeding