Non-vitamin K oral anticoagulants (NOACs) are a convenient alternative to warfarin. Unlike warfarin, no reversal agents were available to help manage bleeding in emergency situations in patients receiving a NOAC, however in Canada this will soon change. Last month, the reversal agent for dabigatran, a Factor IIa inhibitor, was approved by the FDA, and this month the last of the Phase III results for andexanet alfa, a reversal agent for the Factor Xa inhibitors, was presented at the American Heart Association 2015 Scientific Sessions.
Results for andexanet alfa showed it was capable of immediately reversing the anticoagulant effect of rivaroxaban in older patients, with no reported serious side effects. Similar findings were reported earlier this year for patients receiving the other Factor Xa inhibitor, apixaban. With this data now available, the drug maker is planning to submit to the FDA before the end of the year. Once available, these agents provide an efficient solution for emergency situations when bleeding can’t be controlled in a patient taking a NOAC.