![]() Further research will help clarify the role of each agent in the management of DOAC-related intracranial hemorrhage. ![]() At this time, clinicians should choose an agent based on individual patient presentation and resource availability. ![]() There were no significant differences in any secondary outcomes.Ĭonclusion and Relevance: Our study found no difference in hemostatic efficacy between andexanet alfa and 4FPCC. andexanet alfa 5 ) hemostasis after administration of each agent. There was no difference in the proportion of patients with excellent (4FPCC 9 vs. Results: A total of 46 patients were included in this study, 15 received 4FPCC (32%) and 31 received andexanet alfa (68%). In addition to hemostatic efficacy per imaging, we assessed disposition location, cerebral performance score, blood product consumption, and the development of a new thrombus. Adults with a diagnosis of intracranial hemorrhage (ICH) were included if they received either 4FPCC or andexanet alfa for reversal of apixaban or rivaroxaban. Methods: This was a retrospective, single-center study conducted in adult patients admitted at a quaternary academic medical center from September 2017 to March 2021. ![]() Objective: The primary objective of this study was to determine if there was a difference in hemostatic efficacy of andexanet alfa and 4FPCC in patients with a factor Xa inhibitor-related intracranial hemorrhage. There is little data comparing the two agents in real-life clinical settings. There are two agents available for DOAC reversal, Coagulation Factor Xa (recombinant), inactivated-zhzo (andexanet alfa, Andexxa®) and 4-factor prothrombin complex concentrate (4FPCC). Current guidelines recommend DOACs (direct oral anticoagulants) as first-line therapy in the treatment of VTE (Venous Thromboembolism) due to their more favorable safety profile. ![]() Background: Mortality of oral anticoagulation-associated ICH is around 60%, with oral anticoagulation increasing the risk of ICH seven to ten-fold compared to no anticoagulation. ![]()
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