The Stroke Journey www.strokejourney.com

For acute care physicians, anticoagulated patients presenting with intracranial hemorrhage (ICH) is an incredibly challenging clinical scenario. ANNEXa-I is a randomized, controlled, clinical trial which provides clinicians with important information on appropriate reversal of anticoagualtion to optimally care for these patients.

Real World studies can provide the foundational support necessary for clinicians to effectively manage anticoagulated patients with severe, often life-threatening intracranial and gastrointestinal bleeding. While randomized controlled clinical trials have provided the initial data necessary for appropriate use of reversal agents such as andexanet alfa for Factor Xa associated bleeding, broader studies enrolling thousands of patients, many with significant co-morbidities, are extremely valuable to clinicians. New information regarding the randomized controlled trial ANEXXA-I, which was halted due to andexanet alfa efficacy, provides additional information supporting reversal therapy for severe bleeding.

Experts in Emergency Medicine, Pharmacy, and Neurocritical Care describe the impact of real world evidence on the care of life-threatening bleeding in the anticoagulated patient. While clinical trial data remain the standard for clinicians, real world data provide important additional information on the use of a particular Repletion or Reversal therapy for these patients.

ICH remains deadly and pathways matter but they aren't always what we need and barriers can be overcome with knowledge.

Coordinating the necessary care for hemorrhagic patients is complicated- learn the ropes from experts on the UC Stroke Team. "Smoother, faster better" is the name of the game.

How and where to treat ICH patients- politics, reversal agents, and science all in one podcast!