ReviewJournal of thrombosis and thrombolysis2015
Managing target-specific oral anticoagulant associated bleeding including an update on pharmacological reversal agents.
Review in Journal of thrombosis and thrombolysis, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding.The American journal of gastroenterology · 2016Guideline
- Article
- Review
- Exploring the effect of factor Xa inhibitors on rotational thromboelastometry: a case series of bleeding patients.Journal of thrombosis and thrombolysis · 2019Article
- Compartment syndrome secondary to an atraumatic gastrocnemius tear in a patient on NOACs: presentation and complications of treatment.BMJ case reports · 2018Article
- Management of Diverticular Hemorrhage: Catching That Culprit Diverticulum Red-Handed!Inflammatory intestinal diseases · 2018Review
- The Anticoagulated trauma patient in the age of the direct oral anticoagulants: a Canadian perspective.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Measurement and reversal of the direct oral anticoagulants.Blood reviews · 2017Review
- Diagnosis and Management of Acute Intracerebral Hemorrhage.Emergency medicine clinics of North America · 2016Review
- New Oral Anticoagulants and Their Reversal Agents.Current treatment options in neurology · 2016Review
- Direct oral anticoagulants and the bleeding patient.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2016Article
- Universal, class-specific and drug-specific reversal agents for the new oral anticoagulants.Journal of thrombosis and thrombolysis · 2016Review
- Widening the path and window of opportunity for FDA approval of non-vitamin K oral anticoagulant specific antidotes and reversal agents.Journal of thrombosis and thrombolysis · 2016Review
- Minimizing bleeding risk in patients receiving direct oral anticoagulants for stroke prevention.International journal of general medicine · 2016Review
- Idarucizumab: First Global Approval.Drugs · 2015Review
- A Systems Pharmacology Model for Predicting Effects of Factor Xa Inhibitors in Healthy Subjects: Assessment of Pharmacokinetics and Binding Kinetics.CPT: pharmacometrics & systems pharmacology · 2015Article
- Apixaban for the prophylaxis and treatment of deep vein thrombosis and pulmonary embolism: an evidence-based review.Therapeutics and clinical risk management · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Target-specific oral anticoagulants (TSOACs) dabigatran, rivaroxaban and apixaban are approved for the prevention and treatment of thromboembolism in several clinical settings. Bleeding is the major complication of anticoagulant therapy, including TSOACs, and anticoagulant reversal strategies are highly desired for the management of anticoagulant-associated major bleeding in addition to maximum supportive care and procedural/surgical intervention. Unlike VKAs for which vitamin K and coagulation factor replacement with prothrombin complex concentrate (PCC) can restore hemostasis, there are no clinically available agents proven to reverse TSOAC anticoagulant effect and ameliorate TSOAC-related major bleeding. This narrative review critically evaluates the evidence for TSOAC reversal using non-specific reversal agents PCC, activated PCC (APCC) and recombinant activated factor VII (rVIIa) which have been assessed primarily using in vitro experiments, animal models and healthy human volunteers. Aripazine is a novel agent undergoing clinical development for non-specific anticoagulant reversal, including TSOACs. Data are presented regarding specific reversal agents idarucizumab (dabigatran) and andexanet alfa (oral factor Xa inhibitors) currently being evaluated in clinical trials. A practical approach to management of patients with TSOAC-associated bleeding is also provided. There is an urgent need for clinical studies that evaluate the efficacy and safety of reversal strategies for TSOAC-related major bleeding with assessment of clinical outcomes such as bleeding and mortality.
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What OpenQuestion holds
Registered trials
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.