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Andexanet, a recombinant decoy protein that binds tightly to the active site of anti–factor Xa anticoagulants, was recently shown to rapidly reverse the anticoagulant effects of rivaroxaban and apixaban in healthy older volunteers (NEJM JW Oncol Hematol Jan 2016, and N Engl J Med 2015; 373:2413).
To further examine the safety and efficacy of using andexanet to reverse anticoagulant-associated bleeding, investigators conducted an industry-sponsored, multicenter, prospective, open-label, single-group study of 67 elderly patients (mean age, 77) with major gastrointestinal bleeding (33 patients), intracranial bleeding (28), or other bleeding (6) associated with the use of rivaroxaban, apixaban, or enoxaparin. Andexanet was given as a bolus dose …