Portola Pharmaceuticals Presents New In Vitro Data | PTLA Message Board Posts

Portola Pharmaceuticals, Inc.

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Msg  6372 of 6728  at  7/8/2019 8:46:44 PM  by


 In response to msg 6370 by  erniewerner
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Re: Portola Pharmaceuticals Presents New In Vitro Data

To the extent people assumed KCentra to be
more effective
than this (like UpToDate guidelines), the PR is good news.  I always assumed KCentra did virtually nothing vs FXa inhibitors, so this isn't necessarily good news to me.

i.e. When life-threatening and high FXa inhibition levels, Andexxa is a lock.  What's needed is more and more expansion into less than absolute life-threatening situations.  But from this PR, we now know maybe 25% of the "potential Andexxa patients" have levels < 75 ng/ml, and might be effectively treated with KCentra.  That's a big chunk.  And I wonder what the FXa inhibition curve looks like at the tail end.  How quickly does it drop off from that reported median level of 94 ng/ml to a potential KCentra level below 75 ng/ml?  If only a few hours, then it could chip away even further.

Other potential factors???

- Maybe with NTP payments, the cost delta isn't a big enough to worry about?  I doubt this because many cases need more than a single dose, so the cost delta is not what I'd call small.

- If prepping Andexxa is a PITA and takes time anyway, you might just have more people sticking with KCentra as first-line, and Andexxa second line therapy.  Say you would've had to wait an hour for A prep, so you decide to just wait a couple hours for 75 ng/ml, then use KCentra.  Again, we're talking outside of life-threatening bleeds, high concentrations, etc).

"For example, in the ANNEXA-4 trial of Andexxa in Factor Xa inhibitor-treated patients with acute major bleeding, approximately 75% of the patients had anticoagulant concentrations above 75 ng/mL at the time of Andexxa reversal therapy."


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Msg # Subject Author Recs Date Posted
6373 Re: Portola Pharmaceuticals Presents New In Vitro Data JoeFlow 8 7/9/2019 7:01:14 AM

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