Reversal of rivaroxaban anticoagulant effect by prothrombin complex concentrates: which dose is sufficient to restore normal thrombin generation?

Lorine Giffard-Quillon; Helene Desmurs-Clavel; Claire Grange; Yohann Jourdy; Yesim Dargaud

doi:10.1186/s12959-020-00228-9

Reversal of rivaroxaban anticoagulant effect by prothrombin complex concentrates: which dose is sufficient to restore normal thrombin generation?

Thromb J. 2020 Aug 24:18:15. doi: 10.1186/s12959-020-00228-9. eCollection 2020.

Authors

Lorine Giffard-Quillon¹, Helene Desmurs-Clavel^{1

2}, Claire Grange^{1

3}, Yohann Jourdy⁴, Yesim Dargaud^{1

4

5}

Affiliations

¹ GEMMAT Groupe d'Etude Multidisciplinaire en Maladies Thrombotiques, Lyon, France.
² Service de Medecine Interne, Medecine Vasculaire, Hopital Edouard Herriot, Lyon, France.
³ Service de Medecine Interne, Medecine Vasculaire, Centre Hospitalier Lyon Sud, Lyon, France.
⁴ Laboratoire d'Hematologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France.
⁵ Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, 28, avenue Doyen J. Lepine, F-69500 Bron, Lyon, France.

Abstract

Rivaroxaban has the most available data to support the use of prothrombin complex concentrates (PCC) as a reversal agent. However, PCC might increase the incidence of thrombotic events by shifting the haemostatic balance towards hypercoagulability. We assessed the in vitro efficacy and safety of three 4-factor PCCs for reversing rivaroxaban anticoagulant effect. Our in vitro finding indicates that 4-factor PCCs at the dose of 25 U.kg^{- 1} may be sufficient to reverse rivaroxaban anticoagulant effect.