MEDIX, God. 21 Br. 118  •  Sponzorirani članak  •  Kardiologija HR ENG

Idarucizumab (Praxbind) – Revolucija u zbrinjavanju krvarenja u bolesnika liječenih dabigatranomIdarucizumab (Praxbind) – a revolution in the treatment of bleeding in patients treated with dabigatran

Daniel Lovrić

Izravni inhibitor trombina, dabigatran, u kliničkim je istraživanjima pokazao povoljan sigurnosni profil uz jednaku ili bolju prevenciju tromboemboličkih događaja u odnosu na varfarin. Do sada je kao jedan od važnijih negativnih čimbenika, unatoč boljim ishodima u bolesnika s krvarenjem pod dabigatranom u odnosu na varfarin, navođen manjak ‚antidota‘ odnosno specifičnoga reverznog agensa koji bi sigurno i brzo neutralizirao njegov antikoagulacijski učinak. Izum idarucizumaba obilježava znatnu prekretnicu u pristupu liječenju bolesnika liječenih antikoagulacijskim lijekovima koji zahtijevaju hitan kirurški ili intervencijski zahvat ili je u njih prisutno nekontrolirano krvarenje. Idarucizumab u potpunosti poništava učinak dabigatrana, a vrijeme djelovanja je praktički trenutno, unutar nekoliko minuta. 

Ključne riječi:
dabigatran, varfarin, idarucizumab, krvarenje

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 21 Br. 118

In clinical studies, direct thrombin inhibitor dabigatran demonstrated a favorable safety profile with equal or better prevention of thromboembolic events compared to warfarin. Despite better outcomes in bleeding patients treated with dabigatran compared to warfarin, a lack of ‘antidote’ i.e. specific reversal agent, which would surely and quickly neutralize its anticoagulant effect, has until now been considered as one of the most important negative side effects. With the arrival of idarucizumab a significant turning point has been achieved in the approach for the treatment of patients treated using anticoagulant drugs, who require urgent surgical or interventional procedures or have been experiencing uncontrolled bleeding. Idarucizumab reverses the effect of dabigatran in 100% of patients within four hours, its onset is within a few minutes while achieving its almost full effect after taking half of a dose. 

Key words:
hemorrhage; dabigatran; idarucizumab; warfarin