Anticoagulant Reversal Agent Safe, Effective

Idarucizumab rapidly and safety reverses the effects of the anticoagulant dabigatran, according to the results of a recent trial.

The humanized monoclonal antibody was developed to reverse the effects of the anticoagulant. Its safety and efficacy were tested in a multicenter, prospective, open-label study involving 503 patients given 5 g of intravenous idarucizumab who either had uncontrolled bleeding (group A) or were about to undergo an urgent procedure (group B).
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Overall, the median maximum percentage reversal of dabigatran was 100%. The median time to cessation of bleeding among patients was 2.5 hours in group A and in group B the median time to the initiation of the intended procedure was 1.6 hours and periprocedural hemostasis was normal in 93.4% of the patients, mildly abnormal in 5.1%, and moderately abnormal in 1.5%.

Thrombotic events occurred in 6.3% of the patients in group A and 7.4% of the patients in group B at 90 days, with mortality rates of 18.8% and 18.9%, respectively.

“In emergency situations, idarucizumab rapidly, durably, and safely reversed the anticoagulant effect of dabigatran,” the researchers concluded.

—Michael Potts

Reference:

Pollack CV, Reilly PA, van Ryn J, et al. idarucizumab for dabigatran reversal — full cohort analysis [published online July 11, 2017]. NEJM. doi:10.1056/NEJMoa1707278.