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The new inhibitors of coagulation factor Xa (fXa) — rivaroxaban (Xarelto) and apixaban (Eliquis) — have several advantages over warfarin, including rapid onset, few drug interactions, and predictable patient responses. However, unlike warfarin, heparin, or low-molecular-weight heparin, the fXa inhibitors currently have no specific antidote that reverses anticoagulation when major bleeding occurs.
A biotech company reports that it has developed an antidote that is very effective in rats: It reverses bleeding caused by the new inhibitors nearly completely, in a dose-dependent manner. The antidote is a synthetic form of coagulation fXa that has been chemically modified to not cause coagulation. However, it binds to the fXa inhibitor drugs and i…