When on the institution site, please use the credentials provided by your institution.Select your institution from the list provided, which will take you to your institution's website to sign in.Click Sign in through your institution.Shibboleth / Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.Ĭhoose this option to get remote access when outside your institution. Typically, access is provided across an institutional network to a range of IP addresses. If you are a member of an institution with an active account, you may be able to access content in one of the following ways: Get help with access Institutional accessĪccess to content on Oxford Academic is often provided through institutional subscriptions and purchases. This paper (i) provides an update on when and how to reverse the DOACs, (ii) describes new reversal agents under development, and (iii) provides a strategic framework for the reversal of the factor XI inhibitors currently under investigation in phase three clinical trials. Reversal can be effected with specific agents, such as idarucizumab for dabigatran and andexanet alfa for apixaban, edoxaban, and rivaroxaban, or with non-specific agents, such as prothrombin complex concentrates, activated prothrombin complex concentrate, and recombinant activated factor VII. Reversal of the anticoagulant effects of the DOACs may be needed in patients with serious bleeding and in those requiring urgent surgery or intervention. Although DOACs are associated with less serious bleeding than vitamin K antagonists, bleeding still occurs with DOACs, particularly in the elderly and in those with comorbidities. Over the past 20 years, there has been a shift from vitamin K antagonists to direct oral anticoagulants (DOACs), which include the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban.

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