Re: Portola Pharmaceuticals Presents New In Vitro Data
1. The 25% ref wasn't from the small "study" but the PR quote of *ANNEXA-4* trial data, I.e. "75% of the patients had anticoagulant concentrations above 75 ng/mL at the time of Andexxa reversal therapy."
That's a lot of patients where KCentra might be effective. I'm only saying the study somewhat supports those that want to be conservative & try KCentra first (cheaper, easier to admin, and well known quantity... and seems to work with moderate or low blood concentrations of FXai)
2. As to "do you think physicians will wait for test results of FXa inhibitor levels in patients admitted with uncontrolled bleeding known to be on NOACs"...
Yes, I think they wait on tox & other lab reports all the time. They need the concentration level to determine Andexxa dosing anyway, and there is a significant delay in even getting Andexxa ordered & constituted for infusion. Patients can be supported with blood, etc. while determining the course of action
Andexxa is doing OK, it isn't flying off the shelf. So the conservatism & use of other therapies *is the current status quo*. Like I said, in critical bleed w high concentrations, Andexxa is a lock, but we want use expanded far beyond that. Does this study help that? Yes. In a major inflection type of way?Probably not. Think of the implications if the study had concluded KCentra seemed to be entirely ineffective in the face of FXa inhibitors. That'd be a game changer.