Abstract Number: PB0402
Meeting: ISTH 2020 Congress
Theme: Coagulation and Natural Anticoagulants » Regulation of Coagulation
Background: Praxbind is an antibody fragment that can effectively and safely reverses the anticoagulant effect of Dabigatran in bleeding patients as well as in patients facing urgent surgery. The 5 g dose used was planned to reverse the 99 percentile of dabigatran levels, however lower doses were also found to neutralize dabigatran effectively.
Aims: To evaluate the use of Praxbind according and the dose administered in bleeding and surgical candidate patients at our center.
Methods: A retrospective cohort of consecutive patients treated with Praxbind between 01/ 2016 to 12/2019 for major bleeding or before urgent invasive procedures. Praxbind dose ((5 gm – HD, 2.5 gm – LD) and the decision for repeated administration was at the discretion of the treating physician. In several patients dabigatran blood levels was take before after (30 min.) administration. Response to treatment was graded as adequate, fair or non-responding.
Results: Twenty six patients were included (13 males, median age 82 years). Dabigatran indication was atrial fibrillation in all patients. In most patients (19/26) Praxbind was administered at LD mainly to treat bleeding (11/19) while the 5g dose was used in 7 patients (3/7 bleeding). A single patient received repeated 5 g doses (15g). Median pre Praxbind blood levels were 104 ng/ml compared to 423 ng/ml (p=0.069) in LD vs. HD treated patients. Post administration median levels was 1 ng/ml in patients receiving LD compared to 0 ng/ml in a single HD patient with available data. In 3 patients response to Praxbind was graded as non-responding, one of which received repeated doses. Eight patients died (mainly infection, one patient died from GI bleeding). In 31% patients Dabigatran treatment was resumed pre-discharged.
Conclusions: In our study cohort low dose Praxbind seemed to be effective in achieving adequate hemostasis un bleeding and surgical patients. This should be confirmed in further patient cohorts.
[Dabigatran blood levels before and after Praxbind administration]
To cite this abstract in AMA style:
Lubetsky A, Kenet G, Barg A, Misgav M. Praxbind for Reversal of Dabigatran: Experience in a Tertiary Hospital [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/praxbind-for-reversal-of-dabigatran-experience-in-a-tertiary-hospital/. Accessed May 1, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/praxbind-for-reversal-of-dabigatran-experience-in-a-tertiary-hospital/