Engineering Reversal - Finding An Antidote For Direct Oral Anticoagulants

The need for oral anticoagulation is rising to combat an increasing prevalence of atrial fibrillation and venous thromboembolism in an aging global population. For more than 65 years, only one class of oral anticoagulants filled this role: vitamin K antagonists, which include warfarin and other coumarin derivatives. However, such drugs require monitoring of the international normalized ratio and subsequent dose adjustment owing to their slow onset and offset and unpredictable pharmacokinetics, along with dietary intake of vitamin K, coexisting illnesses, or other medications. These agents are highly effective in reducing thromboembolic complications (including stroke in patients with atrial fibrillation), but . . .