Written by SMH Public Information Officer Kim Savage
Sarasota Memorial is among a handful of hospitals with the first and only antidote to stop life-threatening or uncontrolled bleeding linked to newer blood thinner medications.
“Factor Xa inhibitors” are a newer type of anticoagulant that is commonly prescribed. These blood thinners are designed to prevent dangerous blood clots in people who are at risk of developing the clots, but the factor Xa inhibitors also increase users’ risk of serious bleeding.
Last year, the US Food and Drug Administration (FDA) granted accelerated approval to andexanet (andexxa), a new drug that can reverse the factor Xa blood-thinning effects. Andexanet is the first agent available to stop life-threatening bleeds in the millions of people who are prescribed factor Xa inhibitors.
As a clinical trial site for andexanet, Sarasota Memorial was able to offer our patients early access to the drug, which has been used to stop uncontrolled bleeding during hemorrhagic strokes, traumatic injuries and critical bleeding emergencies, explained Mauricio Concha, MD, who is the medical director of Sarasota Memorial’s Comprehensive Stroke Center and a site principal investigator in the andexanet studies.
Although andexanet is now widely available, many other hospitals do not offer it, in part because of its high cost and low insurance reimbursement; instead, they often transfer critical patients to Sarasota Memorial Hospital (SMH) or other hospitals that do stock the drug.
“To be effective, andexanet has to be given quickly … usually there’s not enough time to transfer patients to another hospital and still have a good outcome,” Dr. Concha said. “We hope more hospitals will keep a supply on hand. Knowing it’s readily available will reassure doctors who prescribe that class of blood thinners — and their patients — that there is a life-saving option in those rare bleeding emergencies.”
Factor Xa inhibitors are considered safer than other common, prescription blood thinners, like warfarin, because they are less likely to cause intracranial bleeding. However, it is still important to have an antidote to stop bleeding when necessary. Prior to the approval of andexxa, there was no antidote available to reverse the effects of the factor Xa inhibitors, specifically rivaroxaban (Xarelto) and apixaban (eliquis).
Dr. Concha, who conducted the andexanet study with SMH and the Intercoastal Research Center team, co-authored the research study’s final results, which were published this year in the New England Journal of Medicine, and he presented findings at the International Stroke Conference in February 2019.
You can learn more about stroke care and the Comprehensive Stroke Center at smh.com/stroke.
Kim Savage is Sarasota Memorial's public information officer, overseeing media relations and external communications for the health system since 1999.
* Updated from an article that appeared in SMH Today, Spring 2019.