Reversal of Apixaban and Rivaroxaban Anticoagulation by Andexanet Alfa in ANNEXA-A and ANNEXA-R as Assessed by Non-Tissue Factor-Initiated Thrombin Generation Independent of Tissue Factor Pathway Inhibitor

Abstract

Andexanet alfa is a modified factor Xa (FXa) drug designed to bind and sequester FXa inhibitors and thus reverse anticoagulation. The oral presentation reviewed in this article, presented by Dr Genmin Lu at the European Society of Cardiology (ESC) Congress 2018, provides new insights into the effect of the interaction between andexanet alfa and tissue factor (TF) pathway inhibitors on the restoration of thrombin generation (TG) in the TF (extrinsic) and non-TF (intrinsic) coagulation pathways.