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Curr Opin Crit Care · Apr 2020
ReviewAnticoagulation reversal for intracranial hemorrhage in the era of the direct oral anticoagulants.
- Micheal Strein, Scott May, and Gretchen M Brophy.
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia.
- Curr Opin Crit Care. 2020 Apr 1; 26 (2): 122-128.
Purpose Of ReviewThis review focuses on recent relevant literature that examines the reversal of direct oral anticoagulants (DOACs) in patients with intracranial hemorrhage (ICH). The aim of this review is to provide an insightful description of available reversal agents and their clinical utility.Recent FindingsIncreases in prescribing of DOACs has led to the introduction of drug-specific reversal agents. The clinical trials that evaluated these agents did not include a comparator arm making it difficult to determine if they are clinically superior to nonspecific reversal agents.SummaryNumerous options for reversal of DOAC-associated ICH are currently available. Recent clinical trials have demonstrated drug-specific reversal agents are effective in this setting, but additional research is needed to determine whether these agents should be routinely preferred over nonspecific reversal agents.
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