Oral Anticoagulation and the Novel Oral Anticoagulants (NOACs):Where Are We at Midterm?

Academic Content

Program Overview

Faculty Presentations

Introduction Deepak L. Bhatt Elaine Hylek

Video Roundtable

Current Activity

Elaine Hylek, MD, MPH, Boston University School of Medicine, Boston, Massachusetts

NOACs in Clinical Care NOACS Prevention Data NOACS: Major Bleeding Meta-Analysis ESC 2012 Guidelines Update Garfield Registry Prophylaxis vs Anticoagulation Clinical Trial: Major Bleeding Benefit and Risk Bleeding Risk Score Consensus Statements CHA2DS2-VASc Bleeding Risk Score Circulation Article Patient Age vs TTR NOACs vs Warfarin NOACS & Renal Dysfunction EHRA NOACs Practical Guide Procedural Management NOACs Bleeding Management Life-threatening Hemorrhage CAT Scans of Cerebral Hemorrhage Intracerebral Hemorrhage: Limited Data Kcentra: FDA approval Safety: Meta-analysis Anticoagulation Antidotes Dose Differences: AFib vs VTE NOACS in Clinical Practice Continuing role for warfarin?

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Anticoagulation Antidotes in Development

The preceding discussion involved antidotes for anticoagulation with warfarin. There are antidotes in development for all of the NOACs (Figure 26). A Phase 3 study, RE-VERSE AD,[18] is currently enrolling patients to look at the efficacy of a monoclonal antibody, idarucizumab, to counter bleeding with dabigatran, and there is also currently a Phase 3 study looking at a molecule, andexanet alfa, that will arrest the anticoagulant effect of the factor Xa inhibitors.

The results of a Phase 2 randomized, double-blind study of andexanet alfa were presented recently at the 2013 annual meeting of the American Society of Hematology.

Hylek EM. Am J Med 2014; 00.