Effect of low- versus high-dose 4-factor prothrombin complex concentrate in factor Xa inhibitor-associated bleeding : A qualitative systematic review

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PURPOSE: The purpose of this review is to evaluate current literature on the treatment of factor Xa inhibitor-associated bleeds with 4-factor prothrombin complex concentrate (4F-PCC), with a focus on the effect of low versus high dosing of 4F-PCC on hemostatic efficacy and safety outcomes.

SUMMARY: A search of PubMed and EBSCOhost was performed to identify studies evaluating patients with a factor Xa inhibitor-bleed treated with 4F-PCC at either low or high doses. Studies of patients receiving alternative reversal agents such as fresh frozen plasma and andexanet alfa or where no comparator group was evaluated were excluded from the analysis. To assess the effect of these 4F-PCC dosing strategies, the primary outcome of interest was hemostatic efficacy. Four studies meeting inclusion criteria were included in this review. In each of the included studies, similar rates of hemostatic efficacy, hospital mortality, and venous thromboembolism were observed in the low- and high-dose cohorts.

CONCLUSION: These results suggest low- and high-dose 4F-PPC may confer similar clinical effectiveness and safety; however, these findings should be evaluated and confirmed with future prospective studies.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists - (2024) vom: 02. März

Sprache:

Englisch

Beteiligte Personen:

Phillips, Anna [VerfasserIn]
Bradley, Colby [VerfasserIn]
Cash, Julie [VerfasserIn]
Sangiovanni, Ryan [VerfasserIn]
Wingerson, Charles [VerfasserIn]

Links:

Volltext

Themen:

Anticoagulation reversal
Bleeding
Factor Xa inhibitors
Hemostasis
Journal Article
Prothrombin complex concentrate

Anmerkungen:

Date Revised 02.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1093/ajhp/zxae009

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369200039