|Trade names||Bevyxxa, Dexxience, other|
|Other names||PRT054021, PRT064445|
|Drug class||Anticoagulant (direct factor Xa inhibitor)|
|Duration of action||≥72 hrs|
|Elimination half-life||19–27 hrs|
|Excretion||85% feces, 11% urine|
|Chemical and physical data|
|Molar mass||451.905 g·mol−1|
|3D model (JSmol)|
Betrixaban, sold under the brand name Bevyxxa among others, was an anticoagulant used to prevent blood clots in veins in at risk adults, hospitalized for an illness. It has a higher rate of bleeding compared to enoxaparin. It was taken by mouth.
Betrixaban was approved for medical use in the United States in 2017; however, has been subsequently discontinued. It was refused approval in Europe in 2018 due to concerns regarding effectiveness and safety.
Mechanism of action
Betrixaban was originally developed by Millennium Pharmaceuticals. Portola Pharmaceuticals acquired rights for betrixaban in 2004 and co-developed it with Merck. In 2011 Merck discontinued joint development.
The drug has undergone clinical trials for prevention of embolism after knee surgery and for prevention of stroke following non-valvular atrial fibrillation. Betrixaban was also studied in a large phase III clinical trial for extended duration thromboprophylaxis in acute ill patients. Previously apixaban and rivaroxaban have failed to show positive risk/benefit ratio in this indication compared to enoxaparin.[non-primary source needed] APEX trial compared betrixaban with enoxaparin and included 7513 patients. Lower rate of VTE events was found in betrixaban arm with no increase in major bleedings compared to enoxaparin. Based on these results betrixaban was approved by FDA on June 23rd, 2017 becoming the first DOAC approved for extended prophylaxis in hospitalized patients.
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