This letter to the editor published in the New England Journal of Medicine reports a pharmacokinetic and pharmacodynamic study in which 80 healthy volunteers received one dose of the new direct oral factor Xa inhibitor edoxaban, followed by an intravenous dose of PER977 at various doses.

Within 10 minutes, administration of PER977 significantly shortened whole-blood clotting time, which was increased by edoxaban. No procoagulant signal was observed.

These results are seducing as they suggest that PER977, presented as a broad-spectrum anticoagulant reversal agent, could be effective to reverse edoxaban. However, as for the two other potential antidotes in development, andexanet alfa and idarucizumab, further studies are needed to demonstrate that PER977 is beneficial. Phase 2 clinical studies are ongoing and we are impatiently waiting for their results.

– Anne Godier

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