Measuring and Reversing the Effect of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs)

Silvain, Jean‐François; Hauguel, Marie; Kernéis, Mathieu; Collet, Jean‐Philippe; Montalescot, Gilles

doi:10.1253/circj.cj-14-1382

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…2 However, in the figure published in their article, thrombin-clotting time (TT) is presented as a third choice for apixaban. 1 In studies performed in order to determine which coagulation assay could be used to assess the effect of apixaban on hemostasis, TT was evaluated by a chronometric method, using reagents from Diagnostica Stago and it was shown that TT is not influenced by apixaban. 2 Indeed, direct or indirect factor Xa inhibitors have no effect on TT and cannot be recommended for monitoring NOACs anticoagulant activity, as referred by others.…”

Section: To the Editormentioning

confidence: 99%

Assessment of the Anticoagulation Activity of Apixaban

Gonçalves

Araújo

2015

Circ J

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Section: To the Editormentioning

confidence: 99%

Assessment of the Anticoagulation Activity of Apixaban

Gonçalves

Araújo

2015

Circ J

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Comparison of prothrombin time tests used in the monitoring of edoxaban and their evaluation as indicators of the reversal effect

Iba

Emmi²,

Hiki

et al. 2016

Int J Hematol

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Clinical demand for the prompt assessment of the activity of direct-acting factor Xa inhibitors in the emergency care setting is increasing. In the present study, we examined whether prothrombin time (PT) tests can serve as a clinically useful indicator of anti-factor Xa activity. In the first series, the in vitro effect of edoxaban on PT was evaluated by spiking human plasma with edoxaban and measuring PT using three different commercial PT tests. In the second series, the reversal effect of prothrombin complex concentrates (PCC) and activated PCC (aPCC) in edoxaban-spiked plasma was evaluated. In the third series, PT of plasma samples from patients administered either 15 or 30 mg/day of edoxaban was assessed, and the results were compared with edoxaban concentrations determined by a calibrated anti-factor Xa activity assay. The spike test revealed that all PT reagents positively correlated with edoxaban. The sensitivity to edoxaban varied among the three reagents and Triniclot(®) Excel S showed the best performance. Prolonged PT by edoxaban was reversed by PCC and aPCC in a dose-dependent manner; however, complete reversal was not achieved. Positive correlation between anti-factor Xa activity and PT was shown in the clinical samples at the edoxaban range from 0 to >300 ng/mL.

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