Specific Reversal of Anti-Factor Xa DOAC Anticoagulation: Incorporating Latest Data into Practice and Institutional Protocols
A Midday Symposium Conducted at the 2022 ASHP Midyear Clinical Meeting and Exhibition
To view a PDF flyer for the program, visit: https://academiccme.com/wp-content/uploads/2022/11/ASHP_DOAC_Program_proof4.indd_.pdf
*In order to attend our midday symposium in person on Tuesday, December 6th at 11:30 am PT, learners must be registered for the 2022 ASHP Midyear Clinical Meeting & Exhibition.
Tuesday, December 6th, 2022
11:30 am – 1:00 pm Pacific Time
Severe and life-threatening hemorrhage in patients receiving anti-FXa DOACs is unusual; especially for the most-feared bleeding complication, ICH, events are significantly less common than for patients on vitamin K antagonists (VKA). Still, these events occur, and there is a need for specific, timely, evidence-guided, and multimodal management of DOAC-treated patients with hemorrhage to avoid worsening morbidity, excessive cost and length of stay, and mortality. Hospital pharmacists play a key role in the management of these emergency cases, often serving as the most knowledgeable resource on hand for the use of reversal and repletion agents. Hospital pharmacists also often develop, oversee, and monitor institutional protocols for the management of DOAC-associated hemorrhage. Finally, hospital pharmacists are often responsible for educating front-line physicians on best practice in managing these challenging patients within the capabilities and confines of the individual facility.
Our expert faculty will review the latest data, specialty society guidelines recommendations, and ongoing trials in this challenging therapeutic area. They will also address best processes for developing an institutional protocol for the streamlines and consistent management of anti- FXa-DOAC associated hemorrhage.
I. Introduction and Welcome, Review Objectives
II. What Is the Difference Between “Reversal” and “Repletion”?
III. Summary of Current Society Guidelines Recommendations for Management of Anti-FXa-DOAC-Associated Hemorrhage
IV. Case Vignettes Demonstrating the Pharmacist’s Optimal Multi-Modal Management of Hemorrhage in Anti-FXa-DOAC-Treated Patients:
a. Acute ICH
b. Acute Severe GI Bleed with Unstable Vital Signs
c. Multisystem Trauma with Unstable Vital Signs
V. Developing Institutional Pathways for Managing Anti-FXa-DOAC-Associated Hemorrhage
VI. Interactive Panel Discussion
- Review the pharmacology and mechanisms of action of andexanet alfa and 4-factor PCC in the management of anti-FXa-DOAC-associated hemorrhage
- Review the latest clinical trial data on reversal/repletion as part of multi-modal management of both ICH and non-ICH events in patients taking anti-FXa DOACs.
- Review the most current society guidelines addressing management of anti-FXa-DOAC-associated hemorrhage.
- Improve competence and confidence in the hospital and ED/ICU pharmacist's role in address and/or lead development of an institutional multi-specialty protocol for the optimal, streamlined management of anti-FXa-DOAC-associated hemorrhage
John Fanikos, RPh, MBA
Assistant Professor of Clinical Pharmacy Practice
Massachusetts College of Pharmacy
Director of Pharmacy Business and Financial Services
Brigham and Women’s Hospital
Robert DiDomenico, PharmD, BCPS-AQ Cardiology, FCCP, HFSA, FACC
Associate Professor, Department of Pharmacy Practice
Cardiovascular Clinical Pharmacist
University of Illinois Hospital & Health Sciences System
Paul P. Dobesh, PharmD, FAHA, FCCP, BCPS, BCCP
Department of Pharmacy Practice and Science
College of Pharmacy
University of Nebraska Medical Center
In support of improving patient care, AcademicCME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Credit Designation Statement
AcademicCME designates this continuing education activity for 1.50 CPE Contact Hours (0.15 CEUs) of continuing pharmacy education credits (UAN JA4008190-0000-22-022-L04-P).
Clinicians should claim only the credit commensurate with the extent of their participation in the activity.
CE Inquiries/Special Needs
For all CE inquiries or special needs, please contact [email protected] or 610-687-3300.
This activity is supported by an independent educational grant from AstraZeneca.
In order to attend our midday symposium in person on Tuesday, December 6th at 11:30 am PT, learners must be registered for the 2022 ASHP Midyear Clinical Meeting & Exhibition.
To register for the conference, visit: