Larsen Frederik Uttenthal, Hvas Anne-Mette, Grove Erik Lerkevang
Ugeskr Laeger. 2016 Oct 3;178(40).
Non-vitamin K oral anticoagulants (NOACs) are alternatives to vitamin K antagonists and provide consistent anticoagulation with equal or better clinical outcome and no need for routine monitoring. Bleeding is a feared complication of anticoagulants. Until recently, no specific agent has been available for reversal of NOACs. Idarucizumab binds dabigatran for rapid reversal of its activity without procoagulant effects. Andexanet alpha (expected release in 2016) and PER977 are antidotes under clinical development. This article summarizes current and potential future options to antagonize NOACs.
非维生素K口服抗凝药(NOACs)是维生素K拮抗剂的替代品,可提供持续的抗凝作用,临床疗效相同或更佳,且无需常规监测。出血是抗凝药令人担忧的并发症。直到最近,还没有可用于逆转NOACs作用的特效药物。依达赛珠单抗可结合达比加群,迅速逆转其活性且无促凝血作用。andexanet alpha(预计2016年上市)和PER977正处于临床开发阶段,是抗凝解毒剂。本文总结了目前以及未来可能用于对抗NOACs的方法。