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Kcentra and andexxa are both reasonable options for factor xa reversal in major bleeding Andexanet alfa with trade names ondexxya (european union) and andexxa (united states) is a recombinant modified human factor xa (fxa) that was developed as a specific antidote for reversal of anticoagulation by fxai as well as antithrombin‐dependent anticoagulation by low‐molecular‐weight heparins. While andexxa appears to have good hemostatic efficacy, it has greater risk of thrombotic events, specifically cerebrovascular events, compared to kcentra, and no differences in mortality.
About Kcentra for Payers
This document provides recommendations for reversing anticoagulants in patients with bleeding complications This study aims to compare the efficacy and outcomes of andexanet alfa and kcentra for reversal of apixaban or rivaroxaban in bleeding or surgical patients It compares different reversal agents, including pcc (kcentra®), and their mechanisms, onset, duration, and notes.
Unlike kcentra, does not include any endogenous anticoagulants
This gives factor ix complex a greater tendency to promote thrombosis However, it is probably riskier and is supported by less evidence, when compared to kcentra. With a paucity of literature comparing the 2 agents, there is clinical. A ct scan reveals a large intraparenchymal hemorrhage, and his last dose of apixaban was four hours ago
Given the severity of the bleed and recent factor xa inhibitor use, the team must decide between kcentra versus andexxa for urgent reversal.
