Optimizing Outcomes for Patients with DOAC-Related Bleeding: A Multidisciplinary Appraisal of Data-Driven Management Strategies Using Specific Reversal Agents

Overview

Provider Statement

This activity is jointly provided by American Academy of CME and Cornerstone Medical Education.

Release date: February 23, 2024
Expiration date: February 23, 2025

Supporter Statement

Support for this accredited continuing education activity has been made possible through an educational grant from AstraZeneca.

Activity Description

This educational initiative is targeted to the multidisciplinary team of physicians who diagnose, evaluate, and treat direct oral anticoagulant (DOAC)-related bleeding events, including neurologists, cardiologists, emergency medicine physicians, gastroenterologists, internists, and primary care physicians, among others. Designed as a dynamic webinar that leverages expert faculty and innovative whiteboard animations to achieve maximal learner engagement, knowledge advancement, and sustained practice improvement, this activity will provide learners with a circumscription of the clinical benefits and risks associated with DOAC usage, inclusive of patient-specific, disease-specific, and drug-specific risk factors, and will employ a customized animated whiteboard explainer video to illustrate the unique pharmacologic mechanisms of established and emerging specific reversal therapeutics. An expert review of the evidentiary base will follow, encompassing completed, ongoing, and planned clinical trials for specific reversal agents, as well as recent readouts and pending regulatory updates that have the potential to meaningfully shift the calculus. The educational session will conclude with a case-based segment that tangibly highlights the imperative need for multidisciplinary collaboration and the importance of individualized, data-driven treatment selection.

Target Audience

Physicians who diagnose, evaluate, and treat DOAC-related bleeding events, with emphasis on the essential need for integrated, collaborative, multidisciplinary management strategies among neurologists, cardiologists, emergency medicine physicians, gastroenterologists, internists, and primary care physicians.

Learning Objectives

Discuss the widespread clinical utility of DOACs, alongside the incidence and patient burden of DOAC-related bleeding, including life-threatening and uncontrolled bleeding events.

Recognize patient-specific factors that increase the risk of bleeding while taking DOACs.

Describe and differentiate the mechanisms of action of andexanet alfa, idarucizumab, and ciraparantag in reversing DOAC-related bleeding.

Evaluate the established and evolving evidentiary base for specific DOAC-reversal agents, highlighting recent readouts, ongoing studies, and pending regulatory updates.

Apply the latest trial evidence, guideline statements, and expert consensus pathways to develop safe, effective DOAC-reversal treatment plans for individual patients across diverse clinical scenarios.

Faculty

Truman J. Milling, Jr., MD, FACEP (Activity Chair)
Associate Professor, Department of Neurology
Dell Medical School, University of Texas at Austin
Austin, TX

Deborah Siegal, MD, MSc, FRCPC
Associate Professor, Department of Medicine
Division of Hematology, University of Ottawa
Ottawa, ON

Geoffrey Barnes, MD, MSc, FACC
Associate Professor of Internal Medicine
Division of Vascular and Cardiovascular Medicine, University of Michigan
Ann Arbor, MI

Reviewers

Maya R. Chilbert, PharmD, BCCP
Clinical Assistant Professor, Department of Pharmacy Practice
Division of Outcomes and Practice Advancement, University of Buffalo School of Pharmacy
Buffalo, NY

Accreditation and Credit Designation

In support of improving patient care, American Academy of CME, Inc. is Jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians
American Academy of CME, Inc., designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Other HCPs
Other members of the care team will receive a certificate of participation.

How to Participate in this Activity and Obtain CME Credit

There are no fees to participate in the activity. Participants must review the activity information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CME credit for your participation, please complete the post-test (achieving a passing grade of 70% or greater), and program evaluation. Your certificate can be printed immediately.

Disclosures

According to the disclosure policy of the Academy, all faculty, planning committee members, editors, managers, and other individuals who are in a position to control content are required to disclose any relationships with any ineligible company(ies). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. Clinical content has been reviewed for fair balance and scientific objectivity, and all of the relevant financial relationships listed for these individuals have been mitigated.

Disclosure of relevant financial relationships are as follows:

Expert faculty report the following relationship(s) with ineligible companies:

Truman J. Milling, Jr., MD, FACEP – has disclosed his participation on an advisory board or consultant role for AstraZeneca and his involvement on the ANNEXA-I executive committee.

Deborah Siegal, MD, MSc, FRCPC – has disclosed receipt of honoraria from BMS, Pfizer, Servier, AstraZeneca, and Roche, all of which were paid directly to her institution.

Geoffrey Barnes, MD, MSc, FACC – has disclosed his participation on an advisory board or consultant role for Pfizer, BMS, Janssen, Bayer, AstraZeneca, Sanofi, Anthos, Abbott Vascular, and Boston Scientific, his participation as a board member for the Anticoagulation Forum, and receipt of grant/research support from Boston Scientific.

Content reviewers report the following relationship(s)

Maya R. Chilbert, PharmD, BCCP – has no relevant financial relationships with ineligible companies to disclose.

Planning committee members report the following relationship(s):

John JD Juchniewicz, MCIS, CHCP, FACEHP, Paul Miniter, MS, - American Academy of CME: No relevant financial relationships with ineligible companies to disclose.

Bryan C. Taylor, PharmD, MBA, Cornerstone Medical Education: No relevant financial relationships with ineligible companies to disclose.

Unlabeled and Investigational Usage

This activity will review one investigational agent, ciraparantag, as part of the evolving body of evidence on this topic.

The opinions expressed in this accredited continuing education activity are those of the faculty, and do not represent those of the Academy or Cornerstone Medical Education. This educational activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically and draw conclusions only after careful consideration of all available scientific information.

Copyright Statement

© 2024. This accredited continuing education activity is held as copyrighted © by American Academy of CME and Cornerstone Medical Education. Through this notice, Academy and Cornerstone grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).

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