Ciraparantag is an anticoagulant reversal agent.1,2 It selectively binds to unfractionated heparin, enoxaparin, and Factor IXa (Kds = 28, 17, and 35 µM, respectively) over edoxaban , rivaroxaban , Factor Xa, Factor IX, thrombin , antithrombin, and fibrinogen, and only weakly binds to an enoxaparin-antithrombin complex and fondaparinux , in cell-free assays.1 Ciraparantag (200 µg/ml) prevents decreases in fibrin diameter induced by the Factor Xa inhibitor edoxaban in isolated human whole blood. It reduces edoxaban-, dabigatran-, apixaban-, rivaroxaban-, unfractionated heparin-, or enoxaparin-stimulated increases in tail transection-induced blood loss in rats.2
1.Kalathottukaren, M.T., Creagh, A.L., Abbina, S., et al.Comparison of reversal activity and mechanism of action of UHRA, andexanet, and PER977 on heparin and oral FXa inhibitorsBlood Adv.2(16)2104-2114(2018) 2.Ansell, J., Laulicht, B.E., Bakhru, S.H., et al.Ciraparantag, an anticoagulant reversal drug: Mechanism of action, pharmacokinetics, and reversal of anticoagulantsBlood137(1)115-125(2021)