BLOOD FACTOR SUCCESS IN REVERSAL OF BLEEDING IN PATIENTS ON DABIGATRAN

Atrium

Objective. This study was conducted to review the available literature on the success of blood factor products in reversal of bleeding in patients on dabigatran. Background. The use of newer oral anticoagulants(OAC),such as dabigatran, has rapidly increased given their convenient dosing and the absence of constant testing. However, these agents still have a high risk of bleeding, and there is limited data on how to adequately reverse this complication. Methods. Two investigators independently conducted a literature search using the EMBASE/ MEDLINE/IPA databases with the following search terms: “Dabigatran AND reversal agents”, and “Dabigatran AND Bleeding”. Controlled trials, case reports and case series for dabigatran were reviewed. Results. Twenty-one case reports, five case series, and zero clinical trials were found. Twenty patients admitted with bleeding complications while taking dabigatran did not receive any blood factors and of these, 13 patients (65%) survived. Twelve patients received rVIIa with survival rate of 58%. Five patients received 4PCC with 60% survival rate. Two patients received 3PCC; one survived. Six patients received FEIBA; five patients survived. Use of blood factors yielded a 1% difference in survival versus the use of no blood factors. Conclusion. More studies must be conducted to confirm effectiveness, standardize dosage, and frequency of administration of blood factors in this situation. Grants. No grant was used for the funding of this study.