Prothrombin Complex Concentrate Reverses the Effects of Rivaroxaban but Not Dabigatran

The race to replace warfarin is fast and furious. Dabigatran, a direct thrombin inhibitor, was approved by the FDA in 2010 for the prevention of thromboembolism in patients with atrial fibrillation, and rivaroxaban, a factor Xa inhibitor, was recently approved for the same indication. Aside from cost, one of the main barriers to widespread use of these new drugs is the lack of a rapid reversal agent.

Prothrombin complex concentrates (PCCs) may reverse the anticoagulant effect induced by thrombin and factor Xa inhibitors because they contain the coagulation factors II, VII, IX, and X in high concentration and enhance thrombin generation. To investigate the use of a PCC to reverse the effects of dabigatran and rivaroxaban, investigators conduc…