Idarucizumab Reverses the Anticoagulant Effect of Dabigatran

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Administration of idarucizumab (an antibody fragment) was found to reverse the anticoagulant effect of dabigatran, according to an article published online in the journal The New England Journal of Medicine.

In this study, 90 patients were split into two groups: group A consisted of 51 patients with serious bleeding and group B was comprised of 39 patients who required an urgent procedure. The patients were administered 5 grams of intravenous idarucizumab in order to determine its capacity to reverse dabigatran’s anticoagulant effects.

Results showed the median maximum percentage of reversal was 100% (95% CI: 100, 100) in 68 patients with elevated dilute thrombin time and 81 patients with an elevated ecarin clotting time.

Idarucizumab immediately normalized test results in most patients (88% to 98%). Furthermore, 79% of patients had unbound dabigatran concentrations that remained below 20 nanogram per milliliter at 24 hours.

Hemostasis was restored at a median of 11.4 hours in 35 patients from group A who were able to be tested.

Similarly, 33 out of 36 patients from group B who underwent a surgical procedure had normal intraoperative hemostasis, two patients had a mildly abnormal hemostasis, and one patient had moderately abnormal hemostasis post-procedure.

One patient who did not have anticoagulants reinitiated experienced a thrombotic event within 72 hours after the administration of idarucizumab.

Patients with brain cancer are at increased risk of deep vein thrombosis and consequently pulmonary
Administration of idarucizumab (an antibody fragment) was found to reverse the anticoagulant effect of dabigatran.
Specific reversal agents for non–vitamin K antagonist oral anticoagulants are lacking. Idarucizumab, an antibody fragment, was developed to reverse the anticoagulant effects of dabigatran.
READ FULL ARTICLE From New England Journal of Medicine

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