Reversal Agents in the Era of NOACs

Journal of Atrial Fibrillation
Hany S AbedRaymond W Sy

Abstract

The incidence and prevalence of atrial fibrillation (AF) is expected to more than double between 2010 and 2030. Accordingly, the use of non-vitamin K oral anticoagulant (NOAC) agents for thromboembolic stroke prevention is anticipated to increase. The development of effective and safe antidotes is needed to address the unmet need for rapid anticoagulation reversal. The immediate role for these novel antidotes is for reversal of NOAC activity in life threatening bleeding and urgent surgical intervention. In addition, reversal agents may play an important role in simplifying bridging protocols in the peri-procedural period for catheter ablation of AF and elective surgery. Currently, novel reversal agents are either decoy drug receptors or small molecule non-specific anticoagulant activity inhibitors. These agents are at various stages of FDA investigation and approval, with emerging prospective data for safety and efficacy. The purpose of this review is to outline the currently developed NOAC molecular antagonists, their potential clinical roles and future directions.

References

Jan 1, 1997·Annals of Internal Medicine·K J Harjai, A A Licata
May 4, 2004·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gianfranco MazzoccaGiorgio Corbucci

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Citations

May 29, 2018·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jessica D Nicholson, Yaman Kaakeh
Sep 19, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Markella MarkouKonstantinos Gousias

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