RIVAROXABAN/APIXABAN/EDOXABAN interfere with
factor Xa enzyme, which is involved in thrombin production
United States-based Portola Pharmaceuticals has received approval from the US Food and Drug Administration (FDA) for the company's Prior Approval Supplement for the manufacturing process of second generation Andexxa [coagulation
factor Xa (recombinant), inactivated-zhzo], it was reported yesterday.
Summary: The oral
factor Xa inhibitor rivaroxaban has shown a favorable wellbeing and efficacy profile as compared to the well known anticoagulant drug warfarin for the prevention and treatment of thromboembolic disorders.
Similarly, rivaroxaban, apixaban, edoxaban, and betrixaban target a different key enzyme in the cascade,
factor Xa. For those confused by the generic DOAC names: for the DOACs directed against
factor Xa, "xa" is included in the name of the drug, which is "banning" the activity of
factor Xa.
As a direct result of this, a new generation of oral anticoagulants has been developed to treat and prevent thromboembolic disorders, the direct thrombin inhibitors and the
factor Xa inhibitors.
(1) Based upon animal studies, ex vivo trials, and trials in healthy human volunteers, it appears that 4F-PCC may have similar efficacy in correcting laboratory measurements of coagulopathy associated with the
factor Xa inhibitors apixaban and rivaroxaban.
Rivaroxaban is a direct, antithrombin-independent
factor Xa inhibitor, which inhibits not only free
factor Xa, but also clot-bound
factor Xa and the prothrombinase complex.
DOACs fall into 2 categories--factor IIa (thrombin) inhibitor (dabigatran) and
factor Xa inhibitors (rivaroxaban, apixaban, edoxaban, and betrixaban).
Andexanet alfa, a recombinant modified human
factor Xa protein, is an antidote recently approved by the United States Food and Drug Administration (FDA) [10] for patients treated with rivaroxaban and apixaban when reversal of anticoagulation is needed for life-threatening bleeding [11].
Factor Xa Inhibitor Prevents Recurrent Blood (lots Better than Aspirin.