The effect of the direct factor Xa inhibitors apixaban and rivaroxaban on haemostasis tests: a comprehensive assessment using in vitro and ex vivo samples

Influence of apixaban on commonly used coagulation assays: results from the Belgian national External Quality Assessment Scheme

“…Among aPTT reagents, there was no appreciable difference in sensitivity at the concentrations tested. Our results confirm and extend previous reports that PT and aPTT reagents are much less sensitive to apixaban than to rivaroxaban, another direct FXa inhibitor with a similar molecular weight, and endorse the recommendations made by the Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis and the British Committee for Standards in Haematology stipulating that laboratories should be aware of the sensitivity of their own reagent/instrument combination to each of the DOAC . The different effects of apixaban and rivaroxaban on the PT and aPTT could be explained by their respective rates of FXa inhibition .…”

Evaluation of the Antithrombotic Effects of Rivaroxaban and Apixaban Using the Total Thrombus-Formation Analysis System®: In Vitro and Ex Vivo Studies

“…Similarly, blood samples were spiked with apixaban stock solutions. The final concentration of apixaban was 450 μM, which corresponded to the peak concentration of apixaban in blood after a dose of 10 mg/day clinically [13, 14]. We immediately evaluated the antithrombotic effects of these spiked blood samples in comparison with thrombus formation in control blood by the T-TAS ® .…”

Measurement and reversal of the direct oral anticoagulants

“…61 Most PT reagents are inadequately sensitive to detect not only on-therapy, but even above on-therapy levels of apixaban with minimal change in values up to concentrations of 200 ng/mL in both patient and spiked samples. 35, 62 …”