TUNE IN: Can the use of a prothrombin complex concentrate (PCC) to stop warfarin-related bleeding be a practice-changer? In the July 23 edition of Circulation, investigators reported that Octaplex, a four-factor PCC (containing coagulation Factors II, VII, IX, and X and Proteins C and S), was faster and safer than fresh frozen plasma; the four-factor PCC was associated with fewer adverse events, faster INR (international normalized ratio) reversal, and less need for red blood cell transfusion. [The US Food & Drug Administration recently accepted Octapharma USA' s Biological License Application for Octaplex.]
In their paper, Jeffrey Joseph Perry, MD, senior scientist in clinical epidemiology at Ottawa Hospital Research Institute in Canada, and colleagues compared the two anticoagulants and assessed adverse events within seven days, including death and thromboembolic events.
“These findings suggest that [the four-factor PCC] should be a preferred choice over plasma for rapid reversal of warfarin induced coagulopathies,” Dr. Perry told Neurology Today. “We believe that this study will result in a change in practice for centers using frozen plasma as first line treatment for rapid reversal of warfarin induced coagulopathies.”
In a video interview with Neurology Today, Neurology Today Editor-in-Chief Steven P. Ringel, MD, and Associate Editor Robert Holloway Jr., MD, discuss the data in the paper and the pros and cons of accepting the authors' conclusions in practice. More needs to be studied in terms of the therapy's cost-effectiveness, the two neurologists agree. But, according to Dr. Holloway, these data provide compelling reasons why neurologists should check to see whether their pharmacies do have PCC in their formularies. See our website for more in-depth coverage of the study in the Sept. 19 Neurology Today, “Prothrombin Complex Concentrate Faster and Safer Than Fresh Frozen Plasma for Urgent Warfarin Reversal”: neurotodayonline.com; watch the video: http://bit.ly/aNQ4KB.