Clotblog with Dr Samuel Goldhaber

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Edoxaban joins the big league of oral anticoagulants

May 9, 2011 17:15 EDT


The Japan health ministry's recent approval of edoxaban for the prevention of DVT and pulmonary embolism for patients undergoing total knee or hip replacement or after hip fracture is a small but important step forward in the prevention of thromboembolism.

See:

Edoxaban earns VTE indication in Japan





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Your comments
Edoxaban joins the big league of oral anticoagulants
# 1 of 3
May 13, 2011 08:11 (EDT)
Denis

Yet another Factor Xa Inhibitor anticoagulant, I will ask the same question I asked when Dabigatran (Pradaxa, Pradax, depending on where in the world you are) came out. Does it have an antidote, how is the anticoagulant effect reversed in case of emergency? As a patient, we have a right to know. When a drug is not FDA approved, it is widely used as a "off tablet or off market"  drug.  Dabigatran is a perfect example of this.

Nobody really talks of this, it's always, "oh, don't worry, we know what to do". REALLY???

Why is it that so many Dr. are prescribing Dabigatran (pradaxa, pradax) for the treatment of VTE?

Yes I know,  edoxaban is only for the prevention of DVT and pulmonary embolism for patients undergoing total knee or hip replacement or after hip fracture in Japan, but soon it will most likely be approved in the US and Canada for the same purpose (the prevention of DVT and pulmonary embolism for patients undergoing total knee or hip replacement or after hip fracture) and patients with VTE will be prescribed edoxaban.

 My question is , "what is the antidote for edoxaban, in case the need arises for an emergency procedure after a car accident on a patient with DVT?"  

 

 

# 2 of 3
May 16, 2011 09:13 (EDT)
Tony
Apparently, recombinant factor VIIa or prothrombin complex concentrate are antidotes to an edoxaban overdose according to a presentation at the ASH meeting in December 2010. See http://ash.confex.com/ash/2010/webprogram/Paper27923.html for the reference.
# 3 of 3
May 16, 2011 09:30 (EDT)
Denis

Thank you very much Tony.

Finally, an answer...

Does anybody object to this answer?


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Who's Talking
Samuel Z Goldhaber, MD
Professor of Medicine
Harvard Medical School
Director, Venous Thromboembolism Research Group
Co-Director, Anticoagulation Management Service
Cardiovascular Division
Brigham and Women's Hospital
Boston, MA