2026 Eastern States Conference

Learning objectives: Audience members will be able to determine if Balfaxar or KCentra is superior in achieving hemostasis in different types of bleeds; brain, gastrointestinal, and other.
Authors: Allison Carmean, PharmD, Jesse Dorchak, PharmD, BCPS; Thomas Simunich, MS, MBA; Jacob Allenbaugh, DO; Lauren DeLong, DO; Shawna Morrissey, DO
Background: Limited research exists on the efficacy of 4-factor Prothrombin complex concentrates (4F-PCCs) to reverse bleeds caused by Warfarin and DOAC use. This study aims to compare the efficacy of Balfaxar or KCentra to reverse various types of bleeds.
Methods: This study is a retrospective study comparing pre/post measures for patients who received KCentra from February 2022 to February 2024 and Balfaxar from March 2024 to March 2026 at CMMC. Initial fixed dosing for both agents consisted of 2,000 units for DOACs and 1,500 units for Warfarin. Supplemental dosing used actual body weight and patients that received supplemental doses have been excluded. Hemostasis will be defined on the CT scan after Balfaxar or KCentra is given to ensure bleeding has stopped and if the lab values below return to normal. Lab values for hemostasis included INR less than 1.5, PT 11-13 seconds, aPTT 25-40 seconds, platelets 150,000-300,000, Hgb > 7, and fibrinogen 200-400. A 6 hour post CT scan was also used to ensure hemostasis was achieved. The analysis of the statistics will be processed and presented at Eastern States.
Results: Results will be presented at Eastern States.
Conclusion: Conclusion will be presented at Eastern States.