PURPOSE: To describe the use of idarucizumab (Praxbind, Boehringer Ingelheim) in routine clinical practice at a large urban academic medical center. SUMMARY: Seven total doses of idarucizumab were administered to six unique patients from October 31, 2015, to October 31, 2016. The reversal agent was used in conjunction with local bleeding control measures, blood product transfusions, and acid-suppressive therapy. In 86% of cases, idarucizumab administration resulted in a successful cessation of bleeding by clinical assessment. Two patients expired due to coexisting conditions. Idarucizumab was administered to patients with normal baseline coagulation tests in 43% of cases. No adverse reactions related to idarucizumab were reported. CONCLUSIONS: Idarucizumab administration resulted in successful resolution of bleeding by clinical assessment. The therapy for acute bleeding with use of dabigatran (Pradaxa, Boehringer Ingelheim) remains supportive care, in addition to idarucizumab in cases of severe or uncontrolled bleeding. Development of institution-specific protocols and better guidance for using baseline coagulation tests are needed.
PURPOSE: To describe the use of idarucizumab (Praxbind, Boehringer Ingelheim) in routine clinical practice at a large urban academic medical center. SUMMARY: Seven total doses of idarucizumab were administered to six unique patients from October 31, 2015, to October 31, 2016. The reversal agent was used in conjunction with local bleeding control measures, blood product transfusions, and acid-suppressive therapy. In 86% of cases, idarucizumab administration resulted in a successful cessation of bleeding by clinical assessment. Two patients expired due to coexisting conditions. Idarucizumab was administered to patients with normal baseline coagulation tests in 43% of cases. No adverse reactions related to idarucizumab were reported. CONCLUSIONS:Idarucizumab administration resulted in successful resolution of bleeding by clinical assessment. The therapy for acute bleeding with use of dabigatran (Pradaxa, Boehringer Ingelheim) remains supportive care, in addition to idarucizumab in cases of severe or uncontrolled bleeding. Development of institution-specific protocols and better guidance for using baseline coagulation tests are needed.
Authors: John E Scarborough; Jessica Schumacher; K Craig Kent; Charles P Heise; Caprice C Greenberg Journal: JAMA Surg Date: 2017-02-15 Impact factor: 14.766
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Authors: Ammar Majeed; Hun-Gyu Hwang; Stuart J Connolly; John W Eikelboom; Michael D Ezekowitz; Lars Wallentin; Martina Brueckmann; Mandy Fraessdorf; Salim Yusuf; Sam Schulman Journal: Circulation Date: 2013-09-30 Impact factor: 29.690
Authors: Stephan Glund; Joachim Stangier; Joanne van Ryn; Michael Schmohl; Viktoria Moschetti; Wouter Haazen; Marina De Smet; Dietmar Gansser; Stephen Norris; Benjamin Lang; Paul Reilly; Jörg Kreuzer Journal: Clin Pharmacokinet Date: 2017-01 Impact factor: 6.447