ANNEXA-1: Andexanet Alfa Associated with Harm in DOAC Reversal
REBEL Cast
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Intro
This chapter explores the implications of andexanet alfa in treating patients with factor 10A inhibitor-related acute intracerebral hemorrhages, emphasizing the need for further research despite its FDA approval. The conversation highlights the importance of a randomized control trial to better understand its effectiveness compared to other treatment options.
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Background: In May of 2018, Andexanet alfa gained accelerated approval by the FDA for the reversal direct oral anticoagulants (DOACs) despite a lack of robust evidence for use. The 2022 AHA/ASA guidelines give the drug a level 2A recommendation and recommend it over the use of 4F-PCC (Greenberg 2022). FDA approval alongside guideline endorsement has ... 
