Khadka Sushmita, Kasireddy Vineela, Dhakal Pravash
Internal Medicine, Guthrie Medical Group/Robert Packer Hospital, Sayre, USA.
Hematology and Oncology, Guthrie Medical Group/Robert Packer Hospital, Sayre, USA.
Cureus. 2020 Jul 13;12(7):e9173. doi: 10.7759/cureus.9173.
Given their ease of use, safety, and efficacy, direct-acting oral anticoagulants (DOACs) are nowadays widely used in patients with atrial fibrillation or venous thromboembolism, with or without an association with malignancy. Andexanet alfa (andexanet) is a recombinant modified human factor Xa decoy protein that reverses the inhibition of factor Xa. After Food and Drug Administration (FDA) approval in May 2018, andexanet has been used for life-threatening bleeding in patients treated with apixaban or rivaroxaban. In this article, we present a single institutional retrospective review of patients receiving andexanet alfa at Guthrie Robert Packer Hospital. A total of four patients in a period of 10 months received andexanet for intracranial bleeding, 50% (2) had excellent hemostasis, 30 days mortality was 75% (3), and 25% (1) had a thromboembolic event. Anticoagulation was never started in all patients. This review tends to show the real-world utilization data of andexanet in a community hospital setting.
鉴于其易用性、安全性和有效性，直接口服抗凝剂（DOACs）如今广泛应用于房颤或静脉血栓栓塞患者，无论是否与恶性肿瘤相关。安多凝血因子（andexanet）是一种重组修饰的人凝血因子Xa诱饵蛋白，可逆转对凝血因子Xa的抑制作用。2018年5月获得美国食品药品监督管理局（FDA）批准后，安多凝血因子已用于接受阿哌沙班或利伐沙班治疗的危及生命的出血患者。在本文中，我们对在格思里·罗伯特·帕克医院接受安多凝血因子治疗的患者进行了单机构回顾性研究。在10个月的时间里，共有4例患者因颅内出血接受了安多凝血因子治疗，50%（2例）止血效果良好，30天死亡率为75%（3例），25%（1例）发生了血栓栓塞事件。所有患者均未开始抗凝治疗。本研究倾向于展示安多凝血因子在社区医院环境中的实际应用数据。
