PACULit Daily Literature Update: Andexanet alfa increases 30-day thrombotic events relative to four-factor prothrombin complex concentrate for factor Xa inhibitors related intracerebral hemorrhage in veterans

Rech MA, Budde E, Evans CT, et al. Andexanet alfa increases 30-day thrombotic events relative to four-factor prothrombin complex concentrate for factor Xa inhibitors-related intracerebral hemorrhage in veterans. Am J Emerg Med. 2025 Jul;97:97-102. doi: 10.1016/j.ajem.2025.07.037. | PMID: 40700941

This comparative cohort study examined 30-day thrombotic events in veterans with factor Xa inhibitor-related intracerebral hemorrhage treated with andexanet alfa compared to those treated with four-factor prothrombin complex concentrate.

Key Learning Points

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  Andexanet alfa treatment was associated with a higher rate of thrombotic events within 30 days compared to four-factor prothrombin complex concentrate.
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  Careful consideration of thrombotic risk is essential when selecting reversal agents for factor Xa inhibitor-related intracerebral hemorrhage.