Andexanet Alfa effectively controls acute major bleeding due to Factor Xa Inhibitors

The key highlights of the study were:

Andexanet alfa reduced anti-FXa activity in patients treated with apixaban, rivaroxaban, edoxaban, and enoxaparin by 93%, 94%, 71%, and 75%, respectively.

Excellent or good hemostasis occurred in 80% of patients with major bleeding.

Thrombotic events occurred in 10% of patients in the safety population, with no thrombotic episodes occurring after oral anticoagulation restart. Median endogenous thrombin potential was within the normal range by the end of andexanet alfa bolus through 24 hours for all FXa inhibitors.

The study supports the use of andexanet alfa as a safe and effective antidote for FXa inhibitors in patients with acute major bleeding.

Source:

Milling, T. J., Jr, Middeldorp, S., Xu, L., Koch, B., Demchuk, A., Eikelboom, J. W., Verhamme, P., Cohen, A. T., Beyer-Westendorf, J., Michael Gibson, C., Lopez-Sendon, J., Crowther, M., Shoamanesh, A., Coppens, M., Schmidt, J., Albaladejo, P., Connolly, S. J., Anand, R., Bastani, A., … Demchuk, A. M. (2023). Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors. In Circulation. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/circulationaha.121.057844.