Indian Journal of Anaesthesia

REVIEW ARTICLE
Year
: 2019  |  Volume : 63  |  Issue : 3  |  Page : 169--181

Novel reversal agents and laboratory evaluation for direct-acting oral anticoagulants (DOAC): An update


Shagun B Shah, Akhilesh Pahade, Rajiv Chawla 
 Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, New Delhi, India

Correspondence Address:
Dr. Shagun B Shah
H. No: 174-175, Ground Floor, Pocket -17, Sector-24, Rohini, Delhi -110 085
India

Novel oral anticoagulants (NOACs) are no longer “novel” but their reversal agents definitely are. Although NOACs enjoy high clinical efficacy, monitoring and reversal of their effect is a challenge which this review attempts to surmount. Ideally, for NOAC activity measurement, specific anti-Factor IIa levels and anti -Factor Xa levels should be monitored (chromogenic assays), but such tests are not readily available. Modifications of the existing coagulation tests catering to this unmet need for quantification of DOAC activity have been reviewed. The available United States Food and Drug Administration (FDA) approved reversal agents, idarucizumab for dabigatrin and andexanet alfa for anti-Xa direct acting oral anticoagulants have given promising results but are prohibitively priced. Medline, Embase, and Scopus databases were thoroughly searched for clinical trials on laboratory investigations and specific as well as non-specific reversal-agents for DOACs.


How to cite this article:
Shah SB, Pahade A, Chawla R. Novel reversal agents and laboratory evaluation for direct-acting oral anticoagulants (DOAC): An update.Indian J Anaesth 2019;63:169-181


How to cite this URL:
Shah SB, Pahade A, Chawla R. Novel reversal agents and laboratory evaluation for direct-acting oral anticoagulants (DOAC): An update. Indian J Anaesth [serial online] 2019 [cited 2019 May 27 ];63:169-181
Available from: http://www.ijaweb.org/article.asp?issn=0019-5049;year=2019;volume=63;issue=3;spage=169;epage=181;aulast=Shah;type=0