Four-factor prothrombin complex concentrate reverses apixaban-associated bleeding in a rabbit model of acute hemorrhage.

摘要: Summary Background Apixaban is a direct factor Xa inhibitor approved for the treatment and prevention of thromboembolic disease. There lack data regarding its reversal in cases acute bleeding or prior to emergency surgery that needs addressing. Objectives This study assessed whether four-factor prothrombin complex concentrate (4F-PCC; Beriplex®/Kcentra®, CSL Behring) can effectively reverse apixaban-associated an vivo rabbit model evaluated correlations between hemostasis vitro coagulation parameters. Methods For dose-finding purposes, anesthetized rabbits were treated with single intravenous dose apixaban (800–1600 μg kg−1) and, following standardized kidney incision, volume blood loss time measured. In subsequent phase, 1200 kg−1 followed by 4F-PCC (6.25–100 IU kg−1), effects on same parameters assessed. parallel, monitored. Results Dose-dependent increases total observed post administration. Preincision resulted statistically significant (all doses) (doses ≥ 12.5 kg−1). Of measured, thrombin generation initiated using RD reagent (phospholipids only) was most sensitive measures 4F-PCC's hemostatic efficacy, although some also whole clotting time. Conclusions In this hemorrhage, showed potential reversing apixaban. Clinical apixaban-treated patients are needed confirm these results.