Andexxa, Inactivated Recombinant Factor Xa, Andexanet alfa

  • Background
  1. Planned release 2018 in U.S.
  • Mechanism
  1. Antidote for Eliquis (Apixaban) or Xarelto (Rivaroxaban), but not other Factor Xa Inhibitors
  2. Andexxa is a Inactivated Recombinant Factor Xa decoy protein that binds Factor Xa Inhibitors
  • Efficacy
  1. Limits progression of bleeding within 12 hours of dose (onset as early as 1 hour)
  2. Ineffective in the 25% of patients who have low anti-Factor Xa Inhibitor
  • Adverse Effects
  1. Expensive: $25,000 to 50,000 per patient
  2. Risk of Hypercoagulability complications (CVA, VTE)