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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 11/2016

01-11-2016 | Critical Care Neurology (K Sheth, Section Editor)

New Oral Anticoagulants and Their Reversal Agents

Authors: Andrea Morotti, MD, Joshua N. Goldstein, MD, PhD

Published in: Current Treatment Options in Neurology | Issue 11/2016

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Opinion statement

Direct oral anticoagulants (DOAC) are an attractive therapeutic option for anticoagulant treatment in the setting of venous thromboembolism or non-valvular atrial fibrillation. These drugs overall appear to have a lower risk of life-threatening hemorrhage than the vitamin K antagonists. In addition, they demonstrate more predictable and stable pharmacokinetics. Measurement of the degree of anticoagulation is desirable in patients with DOAC-associated hemorrhage, but commonly available coagulation assays show poor sensitivity for degree of DOAC effect. DOAC-specific tests are time consuming and not widely available. All coagulation tests should be interpreted considering the timing of last intake and renal function. When life-threatening bleeding occurs, hemostasis should be restored as rapidly as possible. Non-specific prohemostatic drugs may have a role in DOAC reversal, and specific antidotes are at different stages of development. In this review, we provide a summary of DOAC characteristics and an overview of the different therapeutic options available for DOAC reversal.
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Metadata
Title
New Oral Anticoagulants and Their Reversal Agents
Authors
Andrea Morotti, MD
Joshua N. Goldstein, MD, PhD
Publication date
01-11-2016
Publisher
Springer US
Published in
Current Treatment Options in Neurology / Issue 11/2016
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-016-0430-5