II. On the reversal of new oral anti-coagulants: Can we simply extrapolate data from the animal models to humans?

摘要

New oral anti-coagulant agents including direct factor Xa inhibitors (anti-Xa) and direct thrombin inhibitors (anti-IIa) are rapidly entering into clinical practice. These agents have been recently licensed in many countries for postoperative prophylaxis of thromboembolic events after total hip or knee replacement surgery, and they are becoming important options for long-term anti-coagulation therapy for venous thromboprophylaxis, or stroke prevention in non-valvular atrial fibrillation. On the one hand, these drugs are a welcome change for the patients because they seem to provide reliable anti-thrombotic effects without cumbersome laboratory testing and food restrictions.1 On the other hand, the lack of specific antidotes for these agents poses major challenges in the perioperative care and bleeding management