A short review of ciraparantag in perspective of the currently available anticoagulant reversal agents. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Leentjens, J.; Middeldorp, S.; Jung, C.
• Is Part Of: Drug discovery today. Volume 27:Issue 10(2022)
• Publication Date: 2022-10
• Subjects: Ciraparantag -- Anticoagulants -- Antidote -- Idarucizumab -- Andexanet; Drugs -- Design -- Periodicals; Drugs -- Research -- Periodicals; 615.1
• DOI: 10.1016/j.drudis.2022.07.017
• Languages: English
• ISSNs: 1359-6446

Abstract

Highlights: Ciraparantag is a promising new universal anticoagulant reversal agent currently being investigated in a phase 3 trial. Phase 1 and 2 trials show that ciraparantag is an antidote for both heparins and DOAC with a very fast onset of action, no renal clearance and no known drug-drug interactions. None of the currently available anticoagulant antidotes fulfil the criteria of an ideal antidote. Abstract : Despite the improved safety-profile of direct oral anticoagulants (DOACs), bleeding complications remain an important side effect of anticoagulant treatment. Although anticoagulant-specific antidotes are available, an universal anticoagulant reversal agent in case of life-threatening bleeding or emergency surgery is not yet available. Ciraparantag, a synthetic small molecule that inactivates heparins and DOAC, is a promising new reversal agent that has been investigated in phase 2 trials. In this short review we provide an overview of the preclinical and clinical evidence of ciraparantag, and compare strengths and weaknesses of ciraparantag and the currently available anticoagulant reversal strategies.