Abstract Number: PB0295
Meeting: ISTH 2020 Congress
Background: Idarucizumab is the first reversal agent approved for dabigatran and works by binding to the drug compound to neutralize its effect in major bleeding and emergency surgeries. However there is not patients reported outcomes of using idarucizumab “in real world”.
Aims: Analyze the use of idarucizumab as reversal agent of dabigatran in current clinical practice in the hospitals of Aragón (Spain) from 2016 up to now.
Methods: From January-16 to date, 23 patients were registered in this multicenter retrospective study. We analyzed clinical variables and laboratory tests; efficacy, safety and thrombogenic capacity of the idarucizumab and related mortality with its use.
Results: The indications of idarucizumab were emergency surgeries in 16 pts, major bleeding in 6 pts and 1 pt with severe renal failure requiring dialysis received the drug off-label. Surgeries requiring reversal anticoagulation were 1 splenic rupture, 2 aortic dissections, 1 cardiac transplant, 1 cholecystectomy, 1 stroke fibrinolysis, 1 nephrectomy, 3 lower limb thrombectomies, 1 stroke thrombectomy, 1 ankle osteosynthesis, 1 femur fracture, 1 left nephrostomy, 1 strangulated umbilical hernia and 1 drainage subdural hematoma. The use of the drug in major bleeding was 4 pts with intracerebral hemorrhage, 1 with retroperitoneal hemorrhage, 1 lower gastrointestinal bleeding and 1 hematuria. Activated partial thromboplastin time (aPTT) and prothrombin time (PT) were prolonged in 21 patients prior to idarucizumab infusion. Neither adverse effects nor thrombotic events were identified. Four patients died in relation with intraventricular hemorrhage, transplant complications, septic shock and multi-organic failure respectively.
Conclusions: Our series includes 23 patients treated with idarucizumab to reverse the anticoagulation effect of dabigatran in hospitals of Aragon. In our experience “in real world” idarucizumab reversed immediately, completely and safely the anticoagulation with dabigatran. The implementation of multidisciplinary protocols would optimize the cost / effectiveness ratio of idarucizumab in the approved indications.
To cite this abstract in AMA style:Amarilla Lanzas I, Fernández Mosteirín N, Calvo Viñas JM, Sancho Val LI, Cuesta Gallardo I, Gavín Sebastián O. A Multicenter Experience with Idarucizumab “In Real World” as Reversal Anticoagulation of Dabigatran [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-multicenter-experience-with-idarucizumab-in-real-world-as-reversal-anticoagulation-of-dabigatran/. Accessed May 16, 2021.
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