ArticleNature medicine2013
A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa.
Article in Nature medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 234 papers, 7 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
234 citing papers in PubMed, 7 syntheses or guidelines pooled it, 691 citations in OpenAlex.
- Optimal management of cardiac surgery patients using direct oral anticoagulants: recommendations for clinical practice.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2023Pooled it
- 2021 Focused Update Consensus Guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: Executive Summary.Thrombosis and haemostasis · 2022Guideline
- Management of direct factor Xa inhibitor-related major bleeding with prothrombin complex concentrate: a meta-analysis.Blood advances · 2019Pooled it
- Safety and Efficacy of New Anticoagulants for the Prevention of Venous Thromboembolism After Hip and Knee Arthroplasty: A Meta-Analysis.The Journal of arthroplasty · 2017Pooled it
- Guideline
- European Primary Care Cardiovascular Society (EPCCS) consensus guidance on stroke prevention in atrial fibrillation (SPAF) in primary care.European journal of preventive cardiology · 2016Guideline
- Pooled it
- Trial
- A phase 2 PK/PD study of andexanet alfa for reversal of rivaroxaban and edoxaban anticoagulation in healthy volunteers.Blood advances · 2020Trial
- Single-dose ciraparantag safely and completely reverses anticoagulant effects of edoxaban.Thrombosis and haemostasis · 2017Trial
- Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors.The New England journal of medicine · 2016Trial
- Protein C system defects inflicted by the malaria parasite protein PfEMP1 can be overcome by a soluble EPCR variant.Thrombosis and haemostasis · 2015Trial
- Management of pericardial effusion with andexanet alfa during epicardial ventricular tachycardia ablation.Journal of cardiology cases · 2026Article
- Comparing Hemostatic Efficacy of Four-factor Prothrombin Complex Concentrate with Andexanet Alfa in an Apixaban-treated Polytrauma Male Porcine Model.Anesthesiology · 2026Article
- Temporal Coagulation Biomarker Profiles After Andexanet Alfa Use for Procedure-Related Cardiac Tamponade.Journal of cardiovascular electrophysiology · 2026Observational
- TFPIα inhibition by andexanet alfa is partially restored by protein S and factor V-short.Blood advances · 2026Article
- Targeted anticoagulant reversal, unintended consequences: lessons from andexanet alfa.European heart journal. Cardiovascular pharmacotherapy · 2026Article
- Small-molecule binding and sensing with a designed protein family.Nature communications · 2026Article
- Article
- Rapid clearance of achiral small-molecule drugs using de novo-designed proteins and their cyclic and mirror-image variants.Nature biomedical engineering · 2025Article
174 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inhibitors of coagulation factor Xa (fXa) have emerged as a new class of antithrombotics but lack effective antidotes for patients experiencing serious bleeding. We designed and expressed a modified form of fXa as an antidote for fXa inhibitors. This recombinant protein (r-Antidote, PRT064445) is catalytically inactive and lacks the membrane-binding γ-carboxyglutamic acid domain of native fXa but retains the ability of native fXa to bind direct fXa inhibitors as well as low molecular weight heparin-activated antithrombin III (ATIII). r-Antidote dose-dependently reversed the inhibition of fXa by direct fXa inhibitors and corrected the prolongation of ex vivo clotting times by such inhibitors. In rabbits treated with the direct fXa inhibitor rivaroxaban, r-Antidote restored hemostasis in a liver laceration model. The effect of r-Antidote was mediated by reducing plasma anti-fXa activity and the non-protein bound fraction of the fXa inhibitor in plasma. In rats, r-Antidote administration dose-dependently and completely corrected increases in blood loss resulting from ATIII-dependent anticoagulation by enoxaparin or fondaparinux. r-Antidote has the potential to be used as a universal antidote for a broad range of fXa inhibitors.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.