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Newly-developed antidotes for dabigatran and rivaroxaban show promise

For the first time, an antidote developed specifically for dabigatran successfully reversed its anticoagulant effect in healthy volunteers, according to research presented at this week’s American Heart Association’s Scientific Sessions.

It follows a study published earlier this year that showed giving prothrombin complex concentrate to healthy subjects could reverse the effects of rivaroxaban but not dabigatran.

The new study is from researchers who have developed an antibody fragment that specifically binds dabigatran and prevents it from inhibiting clot formation.

It was given as 1 hour or 5-minute infusions to 145 healthy male volunteers and immediate, complete and sustained reversal of dabigatran-induced anticoagulation was seen.

Although the new oral anticoagulants (NOACs) haver distinct advantages over warfarin because they can be prescribed in fixed doses and do not require frequent monitoring, there have been worries about how to stop their anticoagulant effect in patients suffering a major bleed or undergoing emergency surgery.

But the researchers warn the new antidotes are still under development and not yet approved for clinical use.

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