Idarucizumab Effective for Dabigatran Reversal

HealthDay News — An antibody fragment, idarucizumab, can reverse the anticoagulant effects of dabigatran, according to a study published in the New England Journal of Medicine.

Charles V. Pollack Jr., MD, from Pennsylvania Hospital in Philadelphia, and colleagues examined the safety and efficacy of 5 g of intravenous idarucizumab. The interim analysis included 90 patients who received idarucizumab (51 patients who had serious bleeding [group A] and 39 who required an urgent procedure [group B]).

The researchers found that the median maximum percentage reversal of the anticoagulation effect of dabigatran within four hours after idarucizumab administration was 100% among 68 patients with an elevated dilute thrombin time and 81 patients with an elevated ecarin clotting time at baseline. In 88 to 98% of the patients, idarucizumab normalized the test results, which was evident within minutes. In 79% of patients, concentrations of unbound dabigatran remained below 20 ng/mL at 24 hours. Hemostasis was restored at a median of 11.4 hours in 35 patients of group A, who could be assessed. Normal intraoperative hemostasis was reported in 33 of 36 patients in group B who underwent a procedure, with mildly and moderately abnormal hemostasis reported in two patients and one patient, respectively.

“Idarucizumab completely reversed the anticoagulant effect of dabigatran within minutes,” the authors write.

The study was funded by Boehringer Ingelheim, the manufacturer of idarucizumab.


  1. Pollack CV et al. N Engl J Med. 2015; doi:10.1056/NEJMoa1502000.