{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:32:32Z","timestamp":1784658752238,"version":"3.55.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T00:00:00Z","timestamp":1586736000000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215120000754_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Individuals on anticoagulation therapy are at increased risk of bleeding, including epistaxis. There is a lack of available reversal agents for novel oral anticoagulation therapy.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000754_sec_a2\"><jats:title>Objective<\/jats:title><jats:p>This paper reviews the current literature on epistaxis in the context of novel oral anticoagulation use, in order to recommend guidelines on management.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000754_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>A comprehensive search of published literature was conducted to identify all relevant articles published up to April 2019.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000754_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Patients on oral anticoagulation therapy are over-represented in individuals with epistaxis. Those on novel oral anticoagulation therapy were more likely to relapse compared to patients on classic oral anticoagulants or non-anticoagulated patients. Idarucizumab is an effective antidote for bleeding associated with dabigatran use. Recommendations for epistaxis management in patients on novel oral anticoagulation therapy are outlined.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000754_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>Clinicians need to be aware of the potential severity of epistaxis and the increased likelihood of recurrence. High-quality studies are required to determine the efficacy and safety of andexanet alfa and ciraparantag, as well as non-specific reversal agents.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215120000754","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T09:12:07Z","timestamp":1586769127000},"page":"316-322","source":"Crossref","is-referenced-by-count":8,"title":["Management of epistaxis in patients on novel oral anticoagulation therapy"],"prefix":"10.1017","volume":"134","author":[{"given":"J P K","family":"Ho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Bari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Riffat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,4,13]]},"reference":[{"key":"S0022215120000754_ref23","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1160\/TH16-03-0224","article-title":"Single-dose ciraparantag safely and completely reverses anticoagulant effects of edoxaban","volume":"117","author":"Ansell","year":"2017","journal-title":"Thromb Haemost"},{"key":"S0022215120000754_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.74.868.113"},{"key":"S0022215120000754_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-015-1288-1"},{"key":"S0022215120000754_ref24","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1160\/TH15-03-0192","article-title":"Design and rationale for RE-VERSE AD: a phase 3 study of idarucizumab, a specific reversal agent for dabigatran","volume":"114","author":"Pollack","year":"2015","journal-title":"Thromb Haemost"},{"key":"S0022215120000754_ref14","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2017.223"},{"key":"S0022215120000754_ref15","doi-asserted-by":"publisher","DOI":"10.1136\/emj.10.4.298"},{"key":"S0022215120000754_ref29","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-03-0179"},{"key":"S0022215120000754_ref26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814051"},{"key":"S0022215120000754_ref28","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.029017"},{"key":"S0022215120000754_ref22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707278"},{"key":"S0022215120000754_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12398"},{"key":"S0022215120000754_ref10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905561"},{"key":"S0022215120000754_ref7","first-page":"346","article-title":"Epistaxis and dabigatran, a new non-vitamin K antagonist oral anticoagulant","volume":"65","author":"Callejo","year":"2014","journal-title":"Acta Otolaryngol"},{"key":"S0022215120000754_ref17","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1865.x"},{"key":"S0022215120000754_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.06.018"},{"key":"S0022215120000754_ref31","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/ckj\/sfv001","article-title":"Venovenous haemodiafiltration for the management of dabigatran overdose in intensive care unit","volume":"8","author":"Mariat","year":"2015","journal-title":"Clin Kidney J"},{"key":"S0022215120000754_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2005.11.031"},{"key":"S0022215120000754_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32814b06ed"},{"key":"S0022215120000754_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2018.04.006"},{"key":"S0022215120000754_ref19","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-11-468207"},{"key":"S0022215120000754_ref25","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1160\/TH14-12-1080","article-title":"A randomised study in healthy volunteers to investigate the safety, tolerability and pharmacokinetics of idarucizumab, a specific antidote to dabigatran","volume":"113","author":"Glund","year":"2015","journal-title":"Thromb Haemost"},{"key":"S0022215120000754_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.549"},{"key":"S0022215120000754_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5043-z"},{"key":"S0022215120000754_ref33","first-page":"75","article-title":"Major bleeding with old and novel oral anticoagulants: how to manage it","volume":"268","author":"Di Fusco","year":"2018","journal-title":"Focus on reversal agents. 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