Quick-reversal method may be at hand for new blood thinner

June 20, 2012
Quick-Reversal method may be at hand for new blood thinner
Drugs like apixaban have advantages, but risk for bleeding requires rapid antidote, researchers say.

(HealthDay) -- Newer blood-thinning drugs sometimes have one drawback: In cases where they trigger bleeding, their effects can be tough to reverse compared to the standard anticoagulant, warfarin.

Now, a new study finds there are three different approaches to reverse the action of one new blood thinner, apixaban (Eliquis) -- a drug that's currently under review by the U.S. Federal Drug Administration.

Researchers in Spain noted that it remains unclear which method for reversing this new drug might be best.

"If you have an accident or need , doctors have three ways to reverse [the older, standby blood-thinner] that work in a matter of minutes to hours. In contrast, there is little information on how best to reverse the effects of newer anticoagulants, which can take 10 to 18 hours," study author Dr. Gines Escolar, an associate professor of hematology at the University of Barcelona, explained in an news release.

Newer blood thinners, such as apixaban and rivaroxaban [Xarelto, already FDA-approved], typically require less frequent blood tests compared to warfarin, have fewer interactions with foods or other medications and have less variation in dosages.

Nevertheless, "despite these advantages, there is one common side effect of all blood thinners that can be severe -- excess bleeding," Escolar explained.

In conducting the study, the researchers added a high dose of apixaban to blood from healthy donors to test the effects of various methods of reversing on the new drug. They found that two blood-clotting agents -- prothrombin complex concentrates and activated prothrombin complex concentrates -- were more efficient than recombinant factor VII in reversing apixaban. Recombinant factor VII, however, was the first to produce a blood clot and was also most effective in studies with blood circulating through a damaged blood vessel.

"The good news is that the various applied indicate that these approaches may reverse the effects of apixaban," Escolar concluded. "But, even with the favorable results in perfusion [restoration of blood flow] studies using a damaged vessel, we're far from knowing what will work best in a bleeding patient. Resolving efficacy and safety issues will require a clinical trial."

One expert in the United States said that determining a quick, safe way of reversing apixaban would be key to its use.

"Apixaban, which is being considered for use in the prevention of stroke and systemic embolism in patients with [the irregular heartbeat] atrial fibrillation, can be an attractive alternative to warfarin and heparin also used in similar patients," said Dr. David Friedman, chief of Heart Failure Services at North Shore-LIJ's Plainview Hospital in Plainview, N.Y.

"The hope would be for these researchers to next show a safe, effective and quick way to clinically reverse the effects of apixaban on patients with atrial fibrillation who come to the ER with a new bleeding event," he said. If such a method of reversal is confirmed, "clinicians may start to feel more comfortable with the advantages of these newer medicines," he said.

Apixaban has already been approved in Europe for preventing in adults after knee or hip replacement surgery. The drug is currently under review by the U.S. to prevent stroke in people with atrial fibrillation.

The study, presented in the American Heart Association's Emerging Science Series, was partially funded by Bristol-Myers Squibb, which is developing apixaban.

Explore further: Apixaban superior to warfarin for preventing stroke, reducing bleeding and saving lives

More information: The U.S. National Institutes of Health has more about blood thinners.

Related Stories

Apixaban superior to warfarin for preventing stroke, reducing bleeding and saving lives

August 28, 2011
A large-scale trial finds that apixaban, a new anticoagulant drug, is superior to the standard drug warfarin for preventing stroke and systemic embolism in patients with atrial fibrillation. Moreover, apixaban results in ...

Easy-to-use blood thinners likely to replace Coumadin

February 6, 2012
Within a few years, a new generation of easy-to-use blood-thinning drugs will likely replace Coumadin for patients with irregular heartbeats who are at risk for stroke, according to a journal article by Loyola University ...

ARISTOTLE trial finds new drug may revolutionize the treatment of atrial fibrillation

October 26, 2011
New research has the potential to revolutionize the treatment of atrial fibrillation (AF), a condition affecting a quarter of a million Canadians which is expected to strike even more in the coming years, as the Canadian ...

Recommended for you

Vaccinating against psoriasis, allergies and Alzheimer's a possibility, research shows

October 23, 2017
Research from the Universities of Dundee and Oxford has shown how combining the tetanus vaccine with a viral particle that normally affects cucumbers can be used to treat psoriasis and allergies, and may even protect against ...

Fighting opioid addiction in primary care—new study shows it's possible

October 18, 2017
For many of the 2 million Americans addicted to opioids, getting good treatment and getting off prescription painkillers or heroin may seem like a far-off dream.

With no morphine, 25 million die in pain each year: report

October 13, 2017
Every year, some 25 million people—one in ten of them children—die in serious pain that could have been alleviated with morphine at just a few cents per dose, researchers said Friday.

Study finds few restrictions on Rx opioids through Medicare

October 9, 2017
Medicare plans place few restrictions on the coverage of prescription opioids, despite federal guidelines recommending such restrictions, a new Yale study finds. The research results highlight an untapped opportunity for ...

Nocebo effect: Does a drug's high price tag cause its own side effects?

October 5, 2017
Pricey drugs may make people more vulnerable to perceiving side effects, a new study suggests—and the phenomenon is not just "in their heads."

Pre-packaged brand version of compounded medication to prevent preterm births costs 5,000 percent more

October 2, 2017
Preventing a preterm birth could cost as little as $200 or as much as $20,000, depending on which one of two medications a doctor orders, according to a new analysis from Harvard Medical School.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.