Knowledge Check

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What is andexanet alfa?

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A recombinant human FXa decoy protein that binds FXa
inhibitors

Andexanet alfa may be used to reverse which of the following DOACs?

a

Rivaroxaban

Correct. Rivaroxaban is a factor Xa inhibitor.

b

Dabigatran

Dabigatran inhibits thrombin, not factor Xa.

c

Apixaban

Correct. Apixaban is a factor Xa inhibitor.

Andexanet alfa is a modified version of factor Xa that has been mutated at two key sites.

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What 2 activities of FXa are affected by these mutations?

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Protease activity (active site serine residue mutation)
Membrane binding (Gla domain mutation)

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