Jon Faldasz about Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage
Jon Faldasz, Senior Director of Product and Customer Experience at InsightRX, posted on LinkedIn:
“Thinking on the FDA pulling andexanet alfa, it feels like this didn’t need to be the outcome.
I mean I understand the rationale: 10% of patients experienced a thromboembolic event, 5% more than usual care, and so andexanet alfa should probably not be first line therapy for antiXa reversal. (See)
Title: Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage
Authors: Stuart J. Connolly, Mukul Sharma, Alexander T. Cohen, Andrew M. Demchuk, Anna Członkowska, Arne G. Lindgren, Carlos A. Molina, Daniel Bereczki, Danilo Toni, David J. Seiffge, David Tanne, Else Charlotte Sandset, Georgios Tsivgoulis, Hanne Christensen, Jan Beyer-Westendorf, Jonathan M. Coutinho, Mark Crowther, Peter Verhamme, Pierre Amarenco, Risto O. Roine, Robert Mikulik, Robin Lemmens, Roland Veltkamp, Saskia Middeldorp, Thompson G. Robinson, Truman John Milling, Jr., Vitor Tedim-Cruz, Wilfried Lang, Anders Himmelmann, Per Ladenvall, Mikael Knutsson, Ella Ekholm, Andrew Law, Amanda Taylor, Tetyana Karyakina, Lizhen Xu, Kate Tsiplova, Sven Poli, Bernd Kallmünzer, Christoph Gumbinger, Ashkan Shoamanesh, ANNEXA-I Investigators, AstraZeneca
But what about people who refuse PCC for religious reasons? Shouldn’t this option be available for them? Why does “not as good as the best” translate to “absolutely nobody should be allowed to give or receive it?”
And also, I can’t help but think that this is another case of trying to force fit a single dose on everybody, where a drug that could be fantastic with a little more nuanced dosing is instead entirely removed from the market. Honestly this is why I left my clinical position for a career individualizing drug dosing for patients. We can do better.
AstraZeneca if you’re on board hit me up!”
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