ArticleClinical and translational science2016
Reversibility of Apixaban Anticoagulation with a Four-Factor Prothrombin Complex Concentrate in Healthy Volunteers.
Article in Clinical and translational science, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02270918 (A Phase I Placebo-Controlled, Open-Label, Crossover Study to Assess the Reversibility of Apixaban Anticoagulation With the Four Factor Prothrombin Complex Concentrate Kcentra in Healthy Volunteers), which is not on this map. Cited by 13 papers.
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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.
A Phase I Placebo-Controlled, Open-Label, Crossover Study to Assess the Reversibility of Apixaban Anticoagulation With the Four Factor Prothrombin Complex Concentrate Kcentra in Healthy Volunteers
Who cites it
13 citing papers in PubMed.
- Overcoming inertia in anticoagulant reversal: the current evidence gap and need for critical assessment of factor replacement strategies.Frontiers in cardiovascular medicine · 2026Review
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Beware the counsel of the oracle.Journal of the American College of Emergency Physicians open · 2023Article
- Atraumatic Splenic Rupture on Direct Oral Anticoagulation.Journal of community hospital internal medicine perspectives · 2022Article
- Andexanet versus prothrombin complex concentrates: Differences in reversal of factor Xa inhibitors in in vitro thrombin generation.Research and practice in thrombosis and haemostasis · 2020Article
- Life-threatening pericardial bleed complicating atrial fibrillation ablation associated with edoxaban therapy successfully managed with prothrombin complex concentrate.HeartRhythm case reports · 2020Article
- Reversal of apixaban induced alterations in haemostasis by different coagulation factor concentrates in patients after hip or knee replacement surgery.Blood transfusion = Trasfusione del sangue · 2019Article
- The impact of prothrombin complex concentrates when treating DOAC-associated bleeding: a review.International journal of emergency medicine · 2018Review
- Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal.Anesthesiology · 2018Review
- Pharmacological reversal of the direct oral anticoagulants-A comprehensive review of the literature.Research and practice in thrombosis and haemostasis · 2018Review
- Hyperacute management of intracerebral haemorrhage.Clinical medicine (London, England) · 2018Review
- Andexanet alfa effectively reverses edoxaban anticoagulation effects and associated bleeding in a rabbit acute hemorrhage model.PloS one · 2018Article
- Reversal of direct oral anticoagulants.Vascular health and risk management · 2017Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It was hypothesized that the four-factor prothrombin complex concentrate (4F-PCC) Kcentra 25 unit/kg would reverse impairment of thrombin generation in healthy volunteers dosed with apixaban to steady state. In this randomized, two-period crossover, assessor-blinded trial, 12 healthy subjects received 5 mg apixaban every 12 h. Three h after the fifth dose, four-factor prothrombin complex concentrate (4F-PCC) 25 unit/kg or saline were infused. Serial blood samples were assessed for thrombin generation using PPP-reagent and PPP-reagent low, anti-Xa, PT, and PTT assays. Geometric mean ratio was calculated at 30 min postinfusion, and at 24, 48, and 72 h. Peak thrombin generation was 76% higher at 30 min postinfusion with 4F-PCC (p = 0.025). The difference declined to 24% at 24 h and resolved by 48 h. Other thrombin generation parameters were also partially normalized. There was no difference between 4F-PCC and saline in anti-Xa assessment at 30 min or later time points.
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