Praxbind (idarucizumab) is the first and only specific reversal agent available for a novel oral anticoagulant (NOAC)
Broad availability of Praxbind helps access to reversal in emergency situations for Pradaxa (dabigatran etexilate mesylate) patients
RIDGEFIELD, CT – Today, Boehringer Ingelheim announced that Praxbind® (idarucizumab), a specific reversal agent for Pradaxa® (dabigatran etexilate mesylate), is now stocked in 3,200 hospitals in all 50 states. This represents a significant increase in the availability of Praxbind since March 2016, when it was stocked in 2,200 institutions. Healthcare providers and patients can quickly search for institutions in the U.S. where Praxbind is stocked by using a zip code locator tool available at Praxbind.com.
"Emergency situations are unpredictable and access to a reversal agent is important for the rare events when the anticoagulant effect of Pradaxa must be reversed," said Thomas Seck, M.D., vice president, Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc. "We hope patients are reassured in knowing that a specific reversal agent for a NOAC is widely available."
The U.S. Food and Drug Administration approved Praxbind as a specific reversal agent for Pradaxa in October 2015 under accelerated approval—followed by full approval in April 2018—for use in the event of an urgent procedure/emergency surgery or uncontrollable/life-threatening bleeding.
Praxbind is the first and only specific reversal agent for a novel oral anticoagulant (NOAC), and provides immediate reversal of the anticoagulant effect of Pradaxa. It is highly specific to Pradaxa and offered in a hospital in one, ready-to-administer dose for all Pradaxa patients.
The safety and efficacy of Praxbind in reversing the anticoagulant effect of Pradaxa has been demonstrated through the phase III RE-VERSE AD™ study, the largest study to investigate a reversal agent for a NOAC. The final results of this study were published in the New England Journal of Medicine in July 2017. Additionally, the ongoing RE-VECTO™ program evaluates usage patterns of Praxbind in the clinical practice setting.
There are serious risks to consider when treating patients with Praxbind, including warnings and precautions for thromboembolic risk, re-elevation of coagulation parameters, hypersensitivity reactions and risks of serious adverse reactions in patients with hereditary fructose intolerance due to sorbitol excipient. The most frequently reported adverse reaction in ≥5% of idarucizumab-treated healthy volunteers was headache (5%). The most frequently reported adverse reactions in ≥5% of patients were constipation (7%) and nausea (5%).
PRAXBIND is distributed by U.S. hospital pharmacy distributors ASD, Cardinal Health, MPB, HD Smith and Morris Dickson. Orders can generally be filled or restocked within 24 hours. Additional information about stocking Praxbind, as well as the zip code locator tool, is available at Praxbind.com or by calling 1‑800‑542‑6257 (Opt 1).
About RE-VERSE AD™
RE-VERSE AD (NCT02104947) is a phase III global study of patients taking dabigatran who require urgent procedures or have uncontrolled bleeding. The final analysis from RE-VERSE AD included data from patients requiring urgent procedures/emergency surgery, e.g. surgery for an open fracture after a fall, or patients with either uncontrolled or life-threatening bleeding complications, e.g. intracranial hemorrhage or severe trauma after a car accident. The primary endpoint, the degree of reversal of the anticoagulant effect of dabigatran (Pradaxa) achieved by idarucizumab within four hours, was measured by dTT and ECT.
The study, which began in May 2014, is the largest study to investigate a reversal agent for a novel oral anticoagulant (NOAC) in real-world emergency settings. It enrolled a total of 503 patients at 173 sites in 39 countries, which were included in one of two groups:
About Praxbind® (idarucizumab)
INDICATIONS AND USAGE
Praxbind® (idarucizumab) is indicated in patients treated with Pradaxa® when reversal of the anticoagulant effects of dabigatran is needed:
IMPORTANT SAFETY INFORMATION ABOUT PRAXBIND
WARNINGS AND PRECAUTIONS
Thromboembolic Risk
Re-elevation of Coagulation Parameters
Hypersensitivity Reactions
Risk in Patients With Hereditary Fructose Intolerance
ADVERSE REACTIONS
USE IN SPECIFIC POPULATIONS
Pregnancy and Lactation
About Pradaxa® (dabigatran etexilate mesylate)
Indications and Usage
Pradaxa® (dabigatran etexilate mesylate) capsules is indicated:
IMPORTANT SAFETY INFORMATION ABOUT PRADAXA
WARNING: (A) PREMATURE DISCONTINUATION OF PRADAXA INCREASES THE RISK OF THROMBOTIC EVENTS, (B) SPINAL/EPIDURAL HEMATOMA
(A) PREMATURE DISCONTINUATION OF PRADAXA INCREASES THE RISK OF THROMBOTIC EVENTS
Premature discontinuation of any oral anticoagulant, including Pradaxa, increases the risk of thrombotic events. If anticoagulation with Pradaxa is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant
(B) SPINAL/EPIDURAL HEMATOMA
Epidural or spinal hematomas may occur in patients treated with Pradaxa who are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include:
Monitor patients frequently for signs and symptoms of neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider the benefits and risks before neuraxial intervention in patients who are or will be anticoagulated.
CONTRAINDICATIONS
Pradaxa is contraindicated in patients with:
WARNINGS & PRECAUTIONS
Increased Risk of Thrombotic Events after Premature Discontinuation
Premature discontinuation of any oral anticoagulant, including Pradaxa, in the absence of adequate alternative anticoagulation increases the risk of thrombotic events. If Pradaxa is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant and restart Pradaxa as soon as medically appropriate.
Risk of Bleeding
Thromboembolic and Bleeding Events in Patients with Prosthetic Heart Valves
The use of Pradaxa is contraindicated in patients with mechanical prosthetic valves due to a higher risk for thromboembolic events, especially in the post-operative period, and an excess of major bleeding for Pradaxa vs. warfarin. Use of Pradaxa for the prophylaxis of thromboembolic events in patients with AFib in the setting of other forms of valvular heart disease, including bioprosthetic heart valve, has not been studied and is not recommended.
Effect of P-gp Inducers & Inhibitors on Dabigatran Exposure
Concomitant use of Pradaxa with P-gp inducers (e.g., rifampin) reduces exposure to dabigatran and should generally be avoided. P-gp inhibition and impaired renal function are major independent factors in increased exposure to dabigatran. Concomitant use of P-gp inhibitors in patients with renal impairment is expected to increase exposure of dabigatran compared to either factor alone.
Reduction of Risk of Stroke/Systemic Embolism in NVAF
ADVERSE REACTIONS
The most serious adverse reactions reported with Pradaxa were related to bleeding.
Other Measures Evaluated
In NVAF patients, a higher rate of clinical MI was reported in patients who received Pradaxa (0.7/100 patient-years for 150 mg dose) than in those who received warfarin (0.6).
USE IN SPECIFIC POPULATIONS
Pregnancy: The limited available data on PRADAXA use in pregnant women are insufficient to determine drug-associated risks for adverse developmental outcomes.
Lactation: Breastfeeding is not recommended.
Geriatric: Risk of bleeding increases with age.
Please see full Prescribing Information, including boxed WARNING and Medication Guide.
About Boehringer Ingelheim
Boehringer Ingelheim Pharmaceuticals, Inc., based in Ridgefield, CT, is the largest U.S. subsidiary of Boehringer Ingelheim Corporation.
Boehringer Ingelheim is one of the world's top 20 pharmaceutical companies. Headquartered in Ingelheim, Germany, the company operates globally with approximately 50,000 employees. Since its founding in 1885, the company has remained family-owned and today creates value through innovation for three business areas including human pharmaceuticals, animal health and biopharmaceutical contract manufacturing.
Boehringer Ingelheim is committed to improving lives and providing valuable services and support to patients and their families. Our employees create and engage in programs that strengthen our communities. Please visit our website to learn more about how we make more health for more people through our Corporate Social Responsibility initiatives.
In 2016, Boehringer Ingelheim achieved net sales of about $17.6 billion (15.9 billion euros). R&D expenditure corresponds to 19.6 percent of its net sales.
For more information please visit www.boehringer-ingelheim.us, or follow us on Twitter @BoehringerUS.
Boehringer Ingelheim Pharmaceuticals, Inc. either owns or uses the trademarks Pradaxa®, Praxbind®, RE-VERSE AD™ and RE-VECTO™ under license.
SOURCE Boehringer Ingelheim
Related Links
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