SCCM Resource Library-Andexanet Alfa Is Preferred for Intracerebral Hemorrhage Management

Andexanet Alfa Is Preferred for Intracerebral Hemorrhage Management

Video Transcription

Video Summary

The presentation by Lauren Koffman focuses on the management of intracranial hemorrhage (ICH) associated with factor Xa inhibitors, particularly rivaroxaban and apixaban, using tools like prothrombin complex concentrates (PCC) and indexinet-alpha. She highlights the increased risk of hematoma expansion in anticoagulated patients, which worsens outcomes. The talk details how indexinet-alpha acts by providing an alternative binding site to block factor Xa inhibitors, thus rapidly reversing their anticoagulant effects. Clinical trials reveal indexinet-alpha significantly reduces anti-factor Xa activity and tends to improve hemostatic outcomes, albeit without significant differences in mortality or functional independence compared to PCCs. However, cost-effectiveness analyses suggest potential long-term economic benefits due to improved patient outcomes. The talk underscores the need for broader real-world data, longer-term patient monitoring, and greater hospital availability. National guidelines support using indexinet-alpha for managing factor Xa inhibitor-related ICH.

Asset Caption

45-Minute Session | Pro/Con Debate: Flip It and Reverse It: ICH Management

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

intracranial hemorrhage

factor Xa inhibitors

indexinet-alpha

prothrombin complex concentrates

clinical trials

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.