The first uses of iv. idarucizumab for dabigatran reversal in cases of urgent surgeries in Hungary
█ Case report
DOI: 10.26430/CHUNGARICA.2017.47.1.51
Authors:
Driesz Lajos1, Barabás Éva1, Bodócs Ildikó1, Szántó Zoltán1, Hajdú Attila1, Herr György1, Bencsik Gábor1, Pál László2, Borbola József3
1JNKSZ Megyei Hetényi Géza Kórház-Rendelőintézet, Szolnok
2Boehringer Ingelheim RCV GmbH & Co KG, Magyarországi Fióktelepe, Budapest
3Gottsegen György Országos Kardiológiai Intézet, Budapest
Summary
The first uses of iv. idarucizumab for dabigatran reversal in cases of urgent surgeries in Hungary
At present, the direct thrombin inhibitor dabigatran is the only one amongst the new direct anticoagulants which has an effective, specific reversal agent. The novel agent idarucizumab is a humanized, monoclonal antibody fragment binds to dabigatran within minutes thereby offers an opportunity to induce a safe, long-lasting reverse of the anticoagulant effects of dabigatran. The authors describe the first use of idarucizumab in the country in the cases of urgent surgery. The first case was a 79 years old female patient (23.05.2016) with non-valvular atrial fibrillation of high stroke risk-score and renal dysfunction who was taking dabigatran (2×110 mg/day) when acute abdomen has been developed due to acute cholecystitis and cholecystolithiasis requiring emergency surgery. The second case was a 72 years old male patient with non-valvular atrial fibrillation of high stroke risk score who was on dabigatran therapy (2×150 mg/day), when an acute right shoulder joint inflammation had been developed requiring urgent surgery. The preoperative haemostasis investigation revealed anticoagulant influence in both patients. Both patient was received dabigatran antidote (idarucizumab 2×2,5 g iv.) before the surgery, the antidote was feasible and safe without any side-effect. During the surgeries there was no any uncontrollable bleeding. Both patients received the dabigatran treatment back after their recovery.
ISSUE: CARDIOLOGIA HUNGARICA | 2017 | VOLUME 47, ISSUE 1
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