Antidotes to novel direct oral anticoagulants

Khorev N.G.^1,2, Momot A.P.^1,2, Konkova V.O.¹

1) Altai State Medical University of the Public Health Ministry of the Russian Federation
2) Altai Branch Haematological Scientific Centre of the Public Health Ministry of the Russian Federation, Barnaul, Russia

During the last 10 years, several novel direct oral anticoagulants (NOACs) have entered the clinical arena and were registered in the Russian Federation for use in patients presenting with atrial fibrillation, venous thrombosis, and pulmonary artery thromboembolism. NOACs are classified into two groups: direct thrombin inhibitor (notably dabigatran) and factor Xa inhibitors (including rivaroxaban, apixaban, and edoxaban). Their disadvantage is lack of specific antidotes in case of an emergency situation (injury, infarction, stroke requiring thrombolysis, urgent operation). The review contains the data on the existing therapeutic regimens of treating haemorrhage on the background of taking these coagulants. This is followed by analysing the present-day results of clinical trials aimed at working out pharmaceutical agents (andexanet alpha, idarucizumab, aripazine) being antidotes to direct thrombin inhibitor and the factor Xa inhibitors. Administration of these agents makes it possible to reverse coagulation and minimize the aftermaths of haemorrhage in patients taking these drugs, in emergency situations.

KEY WORDS: andexanet alpha, idarucizumab idarucizumab, aripazine, rivaroxaban, apixaban, dabigatran.

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