How do we implement ANNEXXa-I into our Clinical Practice?

November 30, 2023

For acute care physicians, anticoagulated patients presenting with intracranial hemorrhage (ICH) is an incredibly challenging clinical scenario. ANNEXa-I is a randomized, controlled, clinical trial which provides clinicians with important information on appropriate reversal of anticoagualtion to optimally care for these patients.

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Real World Evidence for Management of Severe Bleeding in the Anticoagulated Patient: Impact of Specific Reversal Therapy for Intracranial Hemorrhage and Gastrointestinal Bleeding

July 28, 2023

Real World studies can provide the foundational support necessary for clinicians to effectively manage anticoagulated patients with severe, often life-threatening intracranial and gastrointestinal bleeding. While randomized controlled clinical trials have provided the initial data necessary for appropriate use of reversal agents such as andexanet alfa for Factor Xa associated bleeding, broader studies enrolling thousands of patients, many with significant co-morbidities, are extremely valuable to clinicians. New information regarding the randomized controlled trial ANEXXA-I, which was halted due to andexanet alfa efficacy, provides additional information supporting reversal therapy for severe bleeding.

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The Role of Real World Evidence in Driving Clinical Care for Anticoagulated Patients with Life-Threatening Bleeding

March 31, 2023

Experts in Emergency Medicine, Pharmacy, and Neurocritical Care describe the impact of real world evidence on the care of life-threatening bleeding in the anticoagulated patient. While clinical trial data remain the standard for clinicians, real world data provide important additional information on the use of a particular Repletion or Reversal therapy for these patients.

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What Are the Barriers to Success When Implementing Care Pathways for ICH Patients?

July 12, 2022

ICH remains deadly and pathways matter but they aren't always what we need and barriers can be overcome with knowledge.

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How Do We Coordinate Care Within Our Hospitals To Improve Outcomes in Hemorrhagic Stroke Patients?

July 5, 2022

Coordinating the necessary care for hemorrhagic patients is complicated- learn the ropes from experts on the UC Stroke Team. "Smoother, faster better" is the name of the game.

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Sep 7

Why Is the Extended Window Controversial and What Happened With the FDA?

Haemin Go posted on 9/7/2021

Moderator: William A. Knight IV, MD, FACEP, FNCS
Other Participants: Stacie L. Demel, DO, PhD

The ECASS 3 trial was an RCT of IV-rtPA in the window of 3-4.5 hrs after onset of stroke symptoms. It was conducted in Europe. The European regulatory bodies have endorsed tPA for that window, but the FDA has not. Listen to two national experts in stroke discuss the trial and the meaning of the endorsement or lack thereof. This podcast is a must for acute stroke practitioners!

Podcast, ED First Patient Contact, Care Team, EM, Neuro, Nursing, Pharm, Stroke Team, Time From Stroke, 01_< 6 hrs, Topics, Controversies, Tx Approach, Types Of Content, Podcast, Testing, Triage & Disability Assessment, Care Team, EM, Neuro, Stroke Team, Fibrinolytic Therapy, Care Team, EM, Hosp Med, Neuro, Neurophys, Stroke Team, Diagnosis, IS, Topics, Controversies, EBM, IV Rx, Lytic Therapy, Standard Care, Treatments, Types of Content, Podcast, ICU & Critical Care, Care Team, Critical Care, Hosp Med, Neuro, Stroke Team, Topics, Bleeding, Controversies, EBM, Types of Content, Podcast, Content Types, Podcast

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2 comments on article "Why Is the Extended Window Controversial and What Happened With the FDA?"

Ken Milne

I watched the video on ECASS-III and you mentioned the controversy in this time window. However, there was no mention of Alper et al reanalysis in the BMJ_EBM that questioned the results? Can you comment? https://ebm.bmj.com/content/25/5/168

Ken Milne

Here was some of our feedback on Alper et al https://ebm.bmj.com/content/early/2020/08/10/bmjebm-2020-111517

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