Idarucizumab
| العنوان: | Idarucizumab |
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| المؤلفون: | Daniel J. Quinlan, Jeffrey I. Weitz, John W. Eikelboom, Joanne van Ryn |
| المصدر: | Circulation. 132:2412-2422 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | medicine.drug_class, Antidotes, Hemorrhage, Pharmacology, Antibodies, Monoclonal, Humanized, Antithrombins, Dabigatran, chemistry.chemical_compound, Edoxaban, Physiology (medical), medicine, Animals, Humans, Stroke, Rivaroxaban, Clinical Trials, Phase I as Topic, business.industry, Anticoagulant, Idarucizumab, medicine.disease, Protein Structure, Tertiary, chemistry, Direct thrombin inhibitor, Anesthesia, Apixaban, Cardiology and Cardiovascular Medicine, business, medicine.drug |
| الوصف: | Four non–vitamin K antagonist oral anticoagulants (NOACs), including the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, are currently licensed as alternatives to heparins and vitamin K antagonists for the prevention and treatment of venous thromboembolism and for the prevention of stroke in patients with nonvalvular atrial fibrillation. Dabigatran is the only NOAC that inhibits thrombin; the others inhibit factor Xa. All of the NOACs are at least as effective as vitamin K antagonists for the prevention of stroke in patients with atrial fibrillation and for the treatment of venous thromboembolism, and they are associated with less life-threatening bleeding, in particular less intracranial hemorrhage.1,2 Nonetheless, serious bleeding can occur with NOACs. In addition, patients taking NOACs may sustain trauma and may require urgent surgery or interventions. Consequently, the availability of specific reversal agents for NOACs could improve patient management during these emergency situations. Idarucizumab is a humanized monoclonal antibody fragment that has been developed as a specific reversal agent for dabigatran. In vitro and ex vivo studies have demonstrated that idarucizumab promptly restores dabigatran-prolonged coagulation parameters to baseline values,3–5 and studies in healthy volunteers and patients with life-threatening bleeding or requiring emergency surgery or invasive procedures show that it completely reverses the anticoagulant effects of dabigatran within minutes in the majority of patients. Idarucizumab was recently licensed in the United States and Europe. This article summarizes the pharmacology and clinical data on the use of idarucizumab to reverse dabigatran. The first step in the development of idarucizumab was to immunize mice with dabigatran-derived haptens coupled to carrier proteins to produce antibodies against dabigatran.3 Monoclonal antibodies exhibiting the highest affinity for dabigatran were selected, and the antigen-binding fragment (Fab) was isolated (Figure 1). Murine protein sequences were replaced … |
| تدمد: | 1524-4539 0009-7322 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2aed74bd192d4c6fb8e2dcd6a36ac0e1 https://doi.org/10.1161/circulationaha.115.019628 |
| رقم الأكسشن: | edsair.doi.dedup.....2aed74bd192d4c6fb8e2dcd6a36ac0e1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244539 00097322 |
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