Reversal of the inhibitory effect of fondaparinux on thrombin generation by rFVIIa, aPCC and PCC.

Adverse events associated with the administration of fondaparinux are mainly bleeding complications. Fondaparinux lacks specific antidotes and there is no routine laboratory assay for monitoring the efficacy of fondaparinux. Thrombin generation test measures the kinetic of thrombin formation over time which is a more complete characterisation of the individual coagulation capacity than classical clot based assays. In the present study the reversal effect of three procoagulant molecules was tested on the anticoagulant effect of fondaparinux. A complete correction of thrombin generating capacity was found with low doses of Feiba while rFVIIa was responsible for a partial correction of the coagulation capacity.