Four factor prothrombin complex concentrate (human): Review of the pharmacology and clinical application for vitamin K antagonist reversal

Theresa N. Kinard, Ravi Sarode

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Vitamin K antagonists (VKAs) have been used for decades for the treatment and prophylaxis of thromboembolic events. Due to their wide range of therapeutic indications, they are the most prescribed oral anticoagulant worldwide. However, they are associated with bleeding complications due to their narrow therapeutic range, variability in individual dose responses and laboratory monitoring, and overdoses. Despite off-label use of 3-factor prothrombin complex concentrates and recombinant activated factor VII, until recently, vitamin K and plasma were the only recommended therapeutic options for reversing VKAs in the USA. In 2013, a 4-factor prothrombin complex concentrate (4F-PCC) was approved in the USA for VKA reversal in patients with bleeding or requiring emergency surgery and invasive procedure. Recent randomized controlled clinical trials have shown that 4F-PCC (Kcentra™) is non-inferior for hemostatic efficacy and superior for international normalized ratio correction as compared to plasma and has a similar safety profile.

Original languageEnglish (US)
Pages (from-to)417-427
Number of pages11
JournalExpert Review of Cardiovascular Therapy
Volume12
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Kcentra™
  • bleeding
  • coagulopathy
  • plasma
  • prothrombin complex concentrate (human)
  • vitamin K antagonist
  • warfarin

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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