Optimisation of the assays for the measurement of clotting factor activity in the presence of rivaroxaban

Gerotziafas, Grigoris T.; Baccouche, Hela; Sassi, Mouna; Galea, Vassiliki; Chaari, Mourad; Hatmi, Mohamed; Samama, M; Elalamy, Ismaı̈l

doi:10.1016/j.thromres.2011.09.004

Cited by 32 publications

(25 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were no signs or symptoms of abnormal bleeding. After reviewing screening coagulation test results: Prothrombin time (PT) 54 s (reference range, 9-12) INR 4.9 (reference range, 0.9-1.2), activated Partial Thromboplastin Time (aPTT) 48 s (reference range, [24][25][26][27][28][29][30][31][32][33][34][35][36], the admitting resident requested information on the INR therapeutic range for rivaroxaban. The Hematology Laboratory medical director educated the resident about direct oral anticoagulant drugs, emphasizing it was inappropriate to use the INR to monitor them.…”

Section: Case Presentationmentioning

confidence: 99%

“…Fortunately, some coagulation tests are not affected by DOACs [30][31][32][33]: Reptilase time, immunoturbidity methods (D-dimer, free protein S antigen, von Willebrand factor antigen), chromogenic methods not involving FXa or FIIa (protein C activity, plasminogen activity), von Willebrand factor ristocetin cofactor assay, and molecular methods (Factor V Leiden). To date, there are no comprehensive reports describing the impact of DOACs on platelet function testing methods.…”

Section: Coagulation Test Interf Erence From Doacsmentioning

confidence: 99%

See 1 more Smart Citation

Novel anticoagulants and laboratory testing

Eby

2013

Int J Lab Hematology

View full text Add to dashboard Cite

Summary The introduction of several oral direct anticoagulants within the past 2–3 years has dramatically changed clinical practice and has also impacted on utilization and interpretation of coagulation laboratory testing. This article reviews the effects of the oral thrombin inhibitor, dabigatran, and the oral factor Xa inhibitors, rivaroxaban and apixaban, on screening and diagnostic coagulation tests, and describes methods for measuring the their anticoagulant activity in plasma. Currently, there are evidence gaps regarding the role of laboratory testing for surveillance and management of adverse events associated with these new anticoagulants which do not require routine therapeutic drug monitoring. This is a rapidly changing field, and coagulation laboratory experts have a major role in ensuring patients receive appropriate testing and accurate interpretations of results.

show abstract

Section: Case Presentationmentioning

confidence: 99%

Section: Coagulation Test Interf Erence From Doacsmentioning

confidence: 99%

Novel anticoagulants and laboratory testing

Eby

2013

Int J Lab Hematology

View full text Add to dashboard Cite

show abstract

“…Several specific coagulation factors were low when initially tested but most of them were normal when repeated at our institution. Recent studies have demonstrated falsely low factor activity Surreptitious intake of rivaroxaban Katragadda et al 575 Table 1 Lab values in a patient with surreptitious intake of rivaroxaban at initial presentation, first hematology consult and a second hematology consult levels when using PT-based and PTT-based assays due to dose-dependent interference from rivaroxaban [17][18][19]. The interference is minimized by serial plasma dilutions up to 1 : 80 and thereby decreasing the drug concentration.…”

Section: Discussionmentioning

confidence: 99%

Steps to diagnosis of a case of surreptitious intake of one of the newer direct oral anticoagulants

Katragadda

Murphy²,

Harris³

et al. 2015

Blood Coagulation &Amp; Fibrinolysis

View full text Add to dashboard Cite

Little is known about the effects of newer oral anticoagulants on various coagulation factors. When presented with a case of intentional or suspected overdose with an abnormal coagulation profile, it is imperative to have a working diagnostic algorithm to narrow the cause to a specific drug or drug class. This may become more crucial and time sensitive when dealing with a case of acute hemorrhage. Here we discuss the first reported case of what appears to be a surreptitious intake of newer oral anticoagulants and the steps leading to the diagnosis.

show abstract

“…However, they efficiently inhibit thrombin generation at very low concentrations 36,37. Thus, it is less probable that fluctuations of plasma proteins, such as those related to inflammation, could influence the antithrombotic efficiency of NOACs.…”

Section: Discussionmentioning

confidence: 99%

New orally active anticoagulant agents for the prevention and treatment of venous thromboembolism in cancer patients

Gerotziafas¹,

Mahé²,

Elalamy³

2014

TCRM

Self Cite

View full text Add to dashboard Cite

Patients with cancer have a 6–7-fold higher risk of venous thromboembolism (VTE) as compared with non-cancer patients. Effective and safe anticoagulation for the prevention and treatment of VTE is the cornerstone of the management of patients with cancer, aiming to decrease morbidity and mortality and to improve quality of life. Unfractionated heparin, low molecular weight heparins, fondaparinux and vitamin K antagonists (VKAs) are used in the prevention and treatment of VTE in cancer patients. Heparins and fondaparinux are administered subcutaneously. VKAs are orally active, but they have a narrow therapeutic window, numerous food and drug interactions, and treatment requires regular laboratory monitoring and dose adjustment. These limitations among others have important negative impact on the quality of life of patients and decrease adherence to the treatment. New orally active anticoagulant (NOAC) agents are specific inhibitors of activated factor Xa (FXa) (rivaroxaban and apixaban) or thrombin (dabigatran). It is expected that NOACs will improve antithrombotic treatment. Cancer patients are a particular group that could benefit from treatment with NOACs. However, NOACs present some significant interactions with drugs frequently used in cancer patients, which might influence their pharmacokinetics, compromising their efficacy and safety. In the present review, we analyzed the available data from the subgroups of patients with active cancer who were included in Phase III clinical trials that assessed the efficacy and safety of NOACs in the prevention and treatment of VTE. The data from the Phase III trials in prophylaxis of VTE by rivaroxaban or apixaban highlight that these two agents, although belonging to the same pharmacological group (direct inhibitors of factor Xa), have substantially different profiles of efficacy and safety, especially in hospitalized acutely ill medical patients with active cancer. A limited number of patients with VTE and active cancer were included in the Phase III trials (EINSTEIN, AMPLIFY, and RE-COVER) which evaluated the efficacy and safety of NOACs in the acute phase and secondary prevention of VTE. Although, from a conceptual point of view, NOACs could be an attractive alternative for the treatment of VTE in cancer patients, the available data do not support this option. In addition, due to the elimination of the NOACs by the liver and renal pathway as well as because of their pharmacological interactions with drugs which are frequently used in cancer patients, an eventual use of these drugs in cancer patients should be extremely cautious and be restricted only to patients presenting with contraindications for low molecular weight heparins, fondaparinux, or VKAs. The analysis of the available data presented in this review reinforces the request for the design of new Phase III clinical trials for the assessment of the efficacy and safety of NOACs in specific populations of patients with cancer.

show abstract

Optimisation of the assays for the measurement of clotting factor activity in the presence of rivaroxaban

Cited by 32 publications

References 7 publications

Novel anticoagulants and laboratory testing

Novel anticoagulants and laboratory testing

Steps to diagnosis of a case of surreptitious intake of one of the newer direct oral anticoagulants

New orally active anticoagulant agents for the prevention and treatment of venous thromboembolism in cancer patients

Contact Info

Product

Resources

About