LAUSR

We kindly thank Dr. Wang and colleagues for their critical reading of our case study of the management of a massive dabigatran overdose.[1] We agree that emergency dialysis, which involves the placement of a large-bore catheter, entails risks in anticoagulated patients. Therefore, we opted to first reverse dabigatran’s anticoagulant activity by the administration of idarucizumab. Because of the referral for emergency dialysis we were able to include this patient in the RE-VERSE AD trial (group of urgent surgery or invasive procedures).[2] After the administration of idarucizumab, dialysis became redundant. Because of the massive overdose, we opted for the reversal agent. While this case illustrates the prompt reversal of dabigatran, we cannot claim that idarucizumab changed the outcome of our patient. We agree that an expectant management is appropriate for most patients who present with overdose, normal renal function, and no bleeding. The data of our patient were included in the interim analysis of the RE-VERSE AD study. As this case was the first experience with idarucizumab as part of the management of a massive overdose of dabigatran, we considered that a more detailed report was of interest for emergency physicians. Given that the RE-VERSE AD study included patients with major bleeding and emergency surgery, the observed thrombotic events and deaths likely reflect the severe comorbidity of these patients. The remark on the empty conflict of interest section is correct. By error, during editorial processing, our disclosures were reported under the “Funding information”. We have submitted a corrigendum to the editorial office.