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With a paucity of literature comparing the 2 agents, there is clinical. Given the severity of the bleed and recent factor xa inhibitor use, the team must decide between kcentra versus andexxa for urgent reversal. Kcentra and andexxa are both reasonable options for factor xa reversal in major bleeding
What Stance Do I Have on KCentra vs Andexxa for DOAC Reversal? - #QLAB
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. A ct scan reveals a large intraparenchymal hemorrhage, and his last dose of apixaban was four hours ago This document provides recommendations for reversing anticoagulants in patients with bleeding complications
It compares different reversal agents, including pcc (kcentra®), and their mechanisms, onset, duration, and notes.
Patients with acute intracerebral hemorrhage who are receiving factor xa inhibitors have a risk of hematoma expansion The effect of andexanet alfa, an agent that reverses the effects of factor xa.
