Pharma Focus Asia
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Portola Pharmaceuticals Introduces Antidote for the Reversal of Factor Xa Inhibitors

Portola Pharmaceuticals develops Andexxa® [coagulation factor Xa (recombinant), inactivated-zhzo], the first and only antidote indicated for patients treated with rivaroxaban and apixaban, when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding.

Andexxa’s rapid reversal of the anticoagulating effects of rivaroxaban and apixaban will help clinicians treat life-threatening bleeds, where every minute counts.

Factor Xa inhibitors uses are rapidly growing because of their efficacy and safety profile compared to enoxaparin and warfarin in preventing and treating thromboembolic conditions such as stroke, pulmonary embolism and venous thromboembolism (VTE).

Andexxa is a first-in-class medicine and it has the potential to save lives and have a major impact on global public health.

Andexxa has received the U.S. Food and Drug Administration (FDA) approval. The approval of Andexxa is supported by data from two Phase 3 ANNEXA studies (ANNEXA-R and ANNEXA-A) published in The New England Journal of Medicine, which evaluated the safety and efficacy of Andexxa in reversing the anticoagulant activity of the Factor Xa inhibitors rivaroxaban and apixaban in healthy volunteers.

Andexxa rapidly and significantly reversed anti-Factor Xa activity (the anticoagulant mechanism of these medicines).

The median decrease in anti-Factor Xa activity from baseline was 97 per cent for rivaroxaban and 92 per cent for apixaban.

Data from 185 evaluable patients showed that Andexxa rapidly and significantly reversed anti-Factor Xa activity when administered as a bolus and sustained this reversal when followed by a 120-minute infusion. The median decrease from baseline was 90 percent for rivaroxaban and 93 percent for apixaban.

The post-marketing requirement is a clinical trial that randomizes patients to receive either Andexxa or usual care (the type of care the enrolling institution would provide in the absence of Andexxa).

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