Current management of emergent anticoagulant reversal in the setting of life threatening bleeding events is not standard. Despite FDA approval of three specific antidotes (Kcentra, Praxbind, and Andexxa), other agents such as 3-factor prothrombin complex concentrate (3PCC), activated-PCC (aPCC), recombinant factor VII (rFVII), and fresh frozen plasma (FFP) have been utilized in various doses and combinations in attempt to reverse oral anticoagulants. Even FDA-approved 4PCC is being used with off-label dosing for warfarin reversal. Given the complexity and variety of treatment algorithms for anticoagulant reversal and a lack of consensus regarding the optimal doses of reversal agents, reversal protocols may vary from institution to institution.
The last survey of anticoagulant reversal practices was published in 2017. Unfortunately, only 48 responses were received, of which only 18 responses represented hospitals from the United States. Given the low response rate in the previous survey, the evolving literature on anticoagulant reversal strategies, as well as the introduction of new reversal agents, differences in practice likely already exist when compared to the 2017 survey. As a result, we aim to identify the current treatment and dosing practices for anticoagulation reversal and invite you to participate by completing our short 5-10 minute online survey.
The study has been evaluated by the University of Tennessee Graduate School of Medicine Institutional Board Review and deemed to be an exempt study. If you choose to participate in this study, please answer all questions honestly and as completely as possible. We ask that you not include your name so that all information remain confidential. Participation in this survey is completely voluntary and you may refuse to participate at any time. If you agree to participate in the survey, please click the following link and proceed through the questionnaire.
Thank you for your time and consideration,
Scott Dietrich, Pharm.D., BCCCP, @PCC_PharmD
Shaun Rowe, Pharm.D., M.S., BCPS, BCCCP, FNCS
Leslie Hamilton, Pharm.D., BCPS, BCCCP, FCCP, FCCM