Universal reversal for heparin
Titrating heparin treatment is a balancing act for hematologists trying to control blood coagulation without causing excessive bleeding. A synthetic heparin reversal agent from The University of British Columbia uses a dendritic polymer to neutralize the anticoagulant and could provide a lower-risk option for preventing bleeding during surgery than protamine, the standard of care.1 The challenge will be finding an industry partner to help move the candidate into clinical trials.
Protamine is the only approved antidote for heparin-based therapies. The cationic peptide works by binding to heparins, which are negatively charged, to form a complex that lacks anticoagulant activity. However, protamine has a narrow therapeutic window, has an unpredictable dose response and can cause significant adverse effects including a sudden drop in peripheral blood pressure, pulmonary hypertension and bradycardia.
"Protamine is a drug that has needed a replacement for a very long time," said James Costin, CMO and VP of clinical and medical affairs at Perosphere Inc. "Anything that can induce reversal of heparin anticoagulants without the liabilities of protamine would be very welcome, especially to cardiovascular surgeons."