New Drug : Andexanet Alfa- Reversal agent for Factor X a inhibitors

NEJM- Nov 2015 – ANNEXA-A and ANNEXA-R ClinicalTrials

As of now the major limiting factor with the use of novel anticoagulants is the absence of  reversal agents in case of bleeding complications.

To find a solution to this problem, a new drug has been recently tested in ANNEXA-A and ANNEXA-R trials. Andexanet alfa, a new drug designed to reverse factor X a inhibition.

In the trial, Andexanet alfa was given to apixaban and rivoraxaban administrated healthy volunteers. Within minutes of administration anti factor Xa activity was reduced by more than 90% without any toxic or serious thrombotic effects.

MI rates with Ticagrelor (from PLATO)

This article in JACC examines the rates of MI in patients with ACS treated with ticagrelor vs clopidogrel.

The rates of overall MI at 12 months:

1. Ticagrelor- 5.8%

2. Clopidogrel – 6.9%

3. Nonprocedural MI (HR: 0.86; 95% CI: 0.74 to 1.01) and MI related to percutaneous      coronary intervention or stent thrombosis tended to be lower with ticagrelor.

click here to read more