Andexanet cost5/27/2023 ![]() ![]() ![]() Two patients had levels within the peak range, one patient had a level below the peak range, and one patient had a level above the peak range. All patients had a detectable anti-Xa DOAC levels prior to administration of andexanet alfa. Two patients had a known time since last dose of oral FXaI. Resultsįour patients were included in the study. ![]() This is a case series of four patients with an anti-Xa DOAC level that received andexanet alfa for oral FXaI reversal in the setting of life-threatening bleeding or prior to procedure. This study aimed to describe the utility of anti-Xa DOAC levels as a decision point to administer andexanet alfa. Decision for use of andexanet alfa is also complicated by its high cost, limited drug availability, and thrombotic risk. Previous studies have shown that clearance of these agents may be impaired by renal and hepatic dysfunction, as well as drug-drug interactions. In practice, time from last dose is often unknown. The ANNEXA-4 investigators administered andexanet alfa to patients within an 18-h from last dose of oral FXaI. Andexanet alfa, a modified recombinant factor Xa (FXa), was FDA approved in 2018 for anticoagulant reversal in patients with life-threatening bleeding associated with FXa inhibitors (FXaI). ![]()
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