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CME

Emergency Management of Bleeding With NOACs: Do We Need a Reversal Agent?

  • Authors: Manesh R. Patel, MD; W. Frank Peacock, MD; John W. Eikelboom, MBBS, MSc
  • CME Released: 11/9/2015
  • THIS ACTIVITY HAS EXPIRED FOR CREDIT
  • Valid for credit through: 11/9/2016
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Target Audience and Goal Statement

This activity is intended for cardiologists, primary care physicians, and emergency medicine physicians.

Non-vitamin K antagonist oral anticoagulants (NOACs) are gradually replacing current vitamin K antagonists in a variety of clinical settings. Reversal agents of the vitamin K antagonists are available, but little is known about reversal agents for NOACs. The goal of this activity is to provide an update on the current NOACs being used by clinicians and the recently developed NOAC reversal agents and lab assays that can be used to measure their effects in emergency bleeding situations.

Upon completion of this activity, participants will be able to:

  1. Identify strategies for the management of bleeding events for patients taking NOACs
  2. Summarize latest clinical trial data on specific reversal agents


Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Moderator(s)

  • Manesh R. Patel, MD

    Associate Professor of Medicine, Duke University Medical Center, Durham, North Carolina

    Disclosures

    Disclosure: Manesh R. Patel, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Bayer HealthCare Pharmaceuticals; Genzyme Corporation; Janssen Pharmaceuticals, Inc.; Merck & Co., Inc.

    Dr Patel does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

    Dr Patel does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelist(s)

  • W. Frank Peacock, MD

    Professor, Baylor College of Medicine, Houston, Texas

    Disclosures

    Disclosure: W. Frank Peacock, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Alere; Beckman Coulter, Inc.; Boehringer Ingelheim Pharmaceuticals, Inc.; Cardiorentis AG; Instrumentation Laboratory; Janssen Pharmaceuticals; Philips Healthcare; Portola Pharmaceuticals, Inc.; Prevencio; Singulex; The Medicines Company; ZS Pharma
    Received grants for clinical research from: Abbott Laboratories; Alere; Banyan; Cardiorentis AG; Janssen Pharmaceuticals; Pfizer Inc; Portola Pharmaceuticals, Inc.; Roche; The Medicines Company
    Owns stock, stock options, or bonds from: Comprehensive Research Associates LLC; Emergencies in Medicine LLC

    Dr Peacock does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

    Dr Peacock does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • John W. Eikelboom, MBBS, MSc

    Associate Professor, McMaster University, Hamilton, Ontario, Canada

    Disclosures

    Disclosure: John W. Eikelboom, MBBS, MSc, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; GlaxoSmithKline; Janssen Pharmaceuticals; Lilly; Pfizer Inc; Sanofi
    Received grants for clinical research from: AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; GlaxoSmithKline; Janssen Pharmaceuticals; Pfizer Inc; Sanofi

    Dr Eikelboom does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

    Dr Eikelboom does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Steering Committee

  • Keith A. A. Fox, MB, ChB

    Professor of Cardiology, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom

    Disclosures

    Disclosure: Keith A. A. Fox, MB, ChB, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; GlaxoSmithKline; Janssen Pharmaceuticals Products, L.P.; Lilly; Sanofi
    Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; Janssen Pharmaceuticals Products, L.P.
    Received grants for clinical research from: AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; GlaxoSmithKline; Janssen Pharmaceuticals Products, L.P.; Lilly

  • Dan Atar, MD

    Professor and Head, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway

    Disclosures

    Disclosure: Dan Atar, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Cardiome Pharma Corp.; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; Merck & Co., Inc.; Nycomed; Pfizer Inc.; Sanofi; Takeda Pharmaceuticals North America, Inc.

  • Lord Ajay K. Kakkar, MD, PhD

    Director, Thrombosis Research Institute; Professor of Surgery, University College London, London, United Kingdom

    Disclosures

    Disclosure: Lord Ajay K. Kakkar, MD, PhD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmcaeuticals, Inc.; Daiichi Sankyo, Inc.; Sanofi
    Received grants for clinical research from: Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.

  • Jessica L. Mega, MD, MPH

    Associate Professor of Medicine, Harvard Medical School; Investigator, TIMI Study Group; Cardiologist, Brigham and Women's Hospital, Boston, Massachusetts

    Disclosures

    Disclosure: Jessica L. Mega, MD, MPH, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: American Genomics; Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals Products, L.P.; Portola Pharmaceuticals, Inc.
    Received grants for clinical research from: Accumetrics, Inc.; Bayer HealthCare Pharmaceuticals; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.; Lilly; Nanosphere, Inc.; Sanofi

  • P. Gabriel Steg, MD

    Professor, Department of Cardiology; Director, Coronary Care Unit, Hôpital Bichat, Service de Cardiologie; Faculté de Médecine Xavier Bichat, Université Paris-Diderot, Paris, France

    Disclosures

    Disclosure: P. Gabriel Steg, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Amarin Corporation plc; AstraZeneca Pharmaceuticals LP; Bayer Healthcare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; GlaxoSmithKline; Janssen Pharmaceuticals, Inc.; Lilly; Merck & Co., Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co., Ltd; Pfizer Inc; Regado Biosciences; Roche; Sanofi; SERVIER; The Medicines Company; VIVUS Inc.
    Received grants for clinical research from: Sanofi; SERVIER
    Owns stock, stock options, or bonds from: Aterovax

  • Alexander G. G. Turpie, MD

    Professor of Medicine, McMaster University, Hamilton, Ontario, Canada

    Disclosures

    Disclosure: Alexander G. G. Turpie, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Portola Pharmaceuticals, Inc.
    Served as a speaker or a member of a speakers bureau for: Bristol-Myers Squibb Company; GlaxoSmithKline; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.; Pfizer Inc

Editor(s)

  • Caroline M. Padbury, B.Pharm

    Lead Scientific Director, Medscape, LLC

    Disclosures

    Disclosure: Caroline M. Padbury, B.Pharm, has disclosed no relevant financial relationships.

  • Soumaya El Rouby, PhD

    Scientific Director, Medscape, LLC

    Disclosures

    Disclosure: Soumaya El Rouby, has disclosed no relevant financial relationships.

CME Reviewer(s)

  • Amy Bernard, MS, BSN, RN-BC

    Lead Nurse Planner, Medscape, LLC

    Disclosures

    Disclosure: Amy Bernard, MS, BSN, RN-BC, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Received grants for clinical research from: Otsuka Pharmaceutical Co., Ltd.
Served as an advisor or consultant for: HeartWare International, Inc; Thoratec Corporation.


Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

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  1. Read the target audience, learning objectives, and author disclosures.
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CME

Emergency Management of Bleeding With NOACs: Do We Need a Reversal Agent?

Authors: Manesh R. Patel, MD; W. Frank Peacock, MD; John W. Eikelboom, MBBS, MScFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME Released: 11/9/2015

Valid for credit through: 11/9/2016

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