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Direct Oral Anticoagulants (DOACs) In The Laboratory: 2015 Review.

D. Adcock, R. Gosselin
Published 2015 · Medicine

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Direct oral anticoagulant therapies, including direct anti-Xa and thrombin inhibitors have recently been introduced and may have advantages over vitamin K antagonists such as warfarin. This review describes briefly the clinical utility and mechanism of action of these agents. Detailed information is provided on effect of these agents on routine assays including the APTT and PT as well as their impact on specialty laboratory assays. Also included are the use of drug specific assays and a discussion of alternative methods to determine relative drug concentration, such as evaluating drug calibrators in APTT and PT assays and using heparin calibrated anti-Xa assays to measure direct Xa inhibitors.
This paper references
10.1160/TH13-10-0871
Performance of coagulation tests in patients on therapeutic doses of rivaroxaban. A cross-sectional pharmacodynamic study based on peak and trough plasma levels.
S. Francart (2014)
10.1111/jth.12149
Measuring oral direct inhibitors of thrombin and factor Xa: a recommendation from the Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis
T. Baglin (2013)
10.1136/postgradmedj-2014-132605
Non-vitamin K antagonist oral anticoagulants (NOACs): clinical evidence and therapeutic considerations
K. Saraf (2014)
10.1160/TH14-02-0161
Influence of dabigatran and rivaroxaban on routine coagulation assays. A nationwide Belgian survey.
M. Van Blerk (2015)
10.1160/TH10-04-0247
Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome.
R. Becker (2010)
10.1016/j.amjcard.2009.07.022
Increasing prevalence of atrial fibrillation and flutter in the United States.
G. Naccarelli (2009)
Comparison of anti-Xa and DRVVT assays in quantifying drug levels in patients on therapeutic dises of rivaroxaban
RC Gosselin (2014)
New oral anticoagulants : a need for laboratory monitoring
H Bounameaux (2010)
10.1055/s-0032-1301415
Determination of rivaroxaban in human plasma samples.
J. Harenberg (2012)
10.5858/arpa.2013-0750-OA
Comparison of anti-Xa and dilute Russell viper venom time assays in quantifying drug levels in patients on therapeutic doses of rivaroxaban.
R. Gosselin (2014)
10.1160/TH07-12-0714
Population pharmacokinetics and pharmacodynamics of once- and twice-daily rivaroxaban for the prevention of venous thromboembolism in patients undergoing total hip replacement.
W. Mueck (2008)
10.1309/AJCPRNUMI4PVSJ7Q
Performance of various laboratory assays in the measurement of dabigatran in patients receiving therapeutic doses: a prospective study based on peak and trough plasma levels.
R. Gosselin (2014)
10.1515/CCLM.2011.134
Laboratory assessment of new anticoagulants
M. Samama (2011)
10.1160/TH09-11-0758
Dabigatran etexilate--a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity.
J. van Ryn (2010)
10.1160/TH10-06-0342
Effects of the oral, direct thrombin inhibitor dabigatran on five common coagulation assays.
T. Lindahl (2011)
10.1182/ASHEDUCATION.V2012.1.460.3798662
Coagulation assays and anticoagulant monitoring
Dorothy M A Funk (2012)
10.2106/JBJS.F.00952
Incidence and short-term outcomes of primary and revision hip replacement in the United States.
C. Zhan (2007)
10.1182/blood-2014-04-571232
Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials.
N. van Es (2014)
10.1007/s11239-011-0591-8
Chromogenic laboratory assays to measure the factor Xa-inhibiting properties of apixaban—an oral, direct and selective factor Xa inhibitor
R. Becker (2011)
Evaluation of the prothrombin time for measuring rivaroxaban plasma concentrations using Please cite this article
MM Samama (2012)
10.1111/jth.12649
Effects of the oral, direct factor Xa inhibitor apixaban on routine coagulation assays and anti‐FXa assays
A. Hillarp (2014)
Clinical practice guide on anticoagulant dosing and management of anticoagulantassociated bleeding complications in adults
M Cushman (2011)
Direct oral anticoagulants compared with vitamin K antagonists for acute thromboembolism: evidence from phase 3 trials. Blood 2014;124:1968–75
N van Es (1968)
10.1111/ijlh.12065
Novel anticoagulants and laboratory testing
C. Eby (2013)
10.1160/TH10-01-0080
Facts and artefacts of coagulation assays for factor Xa inhibitors.
S. Haas (2010)
10.1111/bjh.12052
Effects on routine coagulation screens and assessment of anticoagulant intensity in patients taking oral dabigatran or rivaroxaban: Guidance from the British Committee for Standards in Haematology
T. Baglin (2012)
10.1160/TH11-05-0358
Questions and answers on the use of dabigatran and perspectives on the use of other new oral anticoagulants in patients with atrial fibrillation. A consensus document of the Italian Federation of Thrombosis Centers (FCSA).
V. Pengo (2011)
10.1056/NEJMoa1009638
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.
M. Patel (2011)
10.1160/TH09-03-0176
Assessment of laboratory assays to measure rivaroxaban--an oral, direct factor Xa inhibitor.
M. Samama (2010)
10.1111/jth.12969
Recommendation on the nomenclature for oral anticoagulants: communication from the SSC of the ISTH
G. Barnes (2015)
10.1177/1076029611426282
Evaluation of the Prothrombin Time for Measuring Rivaroxaban Plasma Concentrations Using Calibrators and Controls
M. Samama (2012)
10.4081/ITJM.2013.S8.1
Pharmacology of new oral anticoagulants: mechanism of action, pharmacokinetics, pharmacodynamics
L. Masotti (2013)
10.1111/jth.12702
Determination of dabigatran, rivaroxaban and apixaban by ultra‐performance liquid chromatography – tandem mass spectrometry (UPLC‐MS/MS) and coagulation assays for therapy monitoring of novel direct oral anticoagulants
E. M. H. Schmitz (2014)
10.1309/AJCPQ2NJD3PXFTUG
Laboratory measurements of the oral direct factor Xa inhibitor edoxaban: comparison of prothrombin time, activated partial thromboplastin time, and thrombin generation assay.
Y. Morishima (2015)
Dabigatran versus warfarin in patients with atrial fibrillation.
L. Poller (2009)
10.1160/TH12-12-0898
Impact of apixaban on routine and specific coagulation assays: a practical laboratory guide.
J. Douxfils (2013)
fects of the oral , direct thrombin inhibitor dabigatran on fi ve common assays
Lindahl Tl (2011)
10.1097/MBC.0b013e32834f1b0c
Using the HEMOCLOT direct thrombin inhibitor assay to determine plasma concentrations of dabigatran
J. Stangier (2012)
10.1111/jth.12720
Comparison of the effects of apixaban and rivaroxaban on prothrombin and activated partial thromboplastin times using various reagents
B. Dale (2014)
10.1111/j.1538-7836.2010.04098.x
Effects of the oral, direct factor Xa inhibitor rivaroxaban on commonly used coagulation assays
A. Hillarp (2011)
10.1177/0091270009351883
Clinical Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of the Novel Factor Xa Inhibitor Edoxaban in Healthy Volunteers
Ken-ichiro Ogata (2010)
10.1111/j.1538-7836.2010.03759.x
New oral antithrombotics: a need for laboratory monitoring. Against
H. Bounameaux (2010)
10.1309/AJCPY6G6ZITVKPVH
The effect of dabigatran on select specialty coagulation assays.
D. Adcock (2013)
10.1182/blood-2014-03-563056
Evolving use of new oral anticoagulants for treatment of venous thromboembolism.
C. Yeh (2014)
10.1345/aph.1R179
Dabigatran Effects on the International Normalized Ratio, Activated Partial Thromboplastin Time, Thrombin Time, and Fibrinogen: A Multicenter, In Vitro Study
W. Dager (2012)
10.1093/eurheartj/ehu181
Edoxaban: a focused review of its clinical pharmacology.
G. Lip (2014)
10.1182/asheducation-2012.1.460
Coagulation assays and anticoagulant monitoring.
D. Funk (2012)
10.1160/TH10-05-0328
Clinical laboratory measurement of direct factor Xa inhibitors: anti-Xa assay is preferable to prothrombin time assay.
Y. C. Barrett (2010)
10.1160/TH14-04-0361
Evaluating the use of commercial drug-specific calibrators for determining PT and APTT reagent sensitivity to dabigatran and rivaroxaban.
R. Gosselin (2015)
10.1016/S0084-3873(12)00242-8
Apixaban versus Warfarin in Patients with Atrial Fibrillation
C. Rowley (2012)
10.1111/jth.12308
Performance of coagulation tests in patients on therapeutic doses of dabigatran: a cross‐sectional pharmacodynamic study based on peak and trough plasma levels
E. Hawes (2013)
10.1177/1060028015578451
Heparin-Calibrated Chromogenic Anti-Xa Activity Measurements in Patients Receiving Rivaroxaban
R. Gosselin (2015)
10.1111/ijs.12295
Management of acute stroke in patients taking novel oral anticoagulants
G. Hankey (2014)
10.1515/cclm-2014-0767
Recent guidelines and recommendations for laboratory assessment of the direct oral anticoagulants (DOACs): is there consensus?
G. Lippi (2015)
10.1111/j.1538-7836.2010.04057.x
Monitoring new oral antithrombotics: what we should know before we can decide
R. al Dieri (2010)
10.1007/s40265-014-0261-1
Edoxaban: An Update on the New Oral Direct Factor Xa Inhibitor
H. Bounameaux (2014)
10.1111/ijlh.12235
Interpretation of coagulation test results under direct oral anticoagulants
H. Mani (2014)



This paper is referenced by
10.1111/bjh.13810
Laboratory measurement of the direct oral anticoagulants
B. Dale (2016)
10.1016/J.MEDCLE.2017.01.011
Intracraneal hemorrhage during apixaban treatment.
Marc Sorigue (2017)
10.1177/1076029619872556
Evaluation of the DOAC-Stop Procedure by LC-MS/MS Assays for Determining the Residual Activity of Dabigatran, Rivaroxaban, and Apixaban
L. Slavík (2019)
10.1055/s-0036-1597564
Thrombophilic Evaluation in Patients with Acute Pulmonary Embolism: Controversies and Evolving Concepts in Deep Venous Thrombosis and Pulmonary Embolism
Scott Manning Stevens (2017)
10.3343/lmo.2020.10.1.25
Performance Evaluation of the CS-5100 Coagulation Analyzer for Special Coagulation Parameters
Bohyun Kim (2019)
10.1177/1076029619867137
Dabigatran Monitoring Was Influenced by Thrombin Time Reagent With Different Thrombin Concentrations
Xiaoping Xu (2019)
Newer Oral Anticoagulant in Chronic Kidney Disease: What we Should Know.
V. K. Jha (2019)
10.1007/s11239-018-1793-0
Assessment of direct oral anticoagulant assay use in clinical practice
Tina M Gu (2018)
10.1111/jcpt.12776
Differences between activities of coagulation factors after one month of therapy with different direct oral anticoagulant in pulmonary embolism patients
Jelena Džudović (2019)
10.1016/j.suc.2017.07.002
Indications and Methods of Anticoagulation Reversal.
Jeremy L Holzmacher (2017)
Anticoagulants Evolving Treatments for Arterial and Venous Thrombosis : Role of the Direct Oral
N. Chan (2016)
10.1007/s10840-017-0274-2
The anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban or rivaroxaban
L. Brendel (2017)
10.1111/jth.14894
Direct oral anticoagulant adsorption: Impact on lupus anticoagulant testing—Review of the literature and evaluation on spiked and patient samples
Pieter M M De Kesel (2020)
10.1016/j.thromres.2020.04.044
Interference of DOAC stop and DOAC remove in the thrombin generation assay and coagulation assays.
Tinne Monteyne (2020)
10.1177/1060028017729481
Influence of Direct Oral Anticoagulants on Anti–Factor Xa Measurements Utilized for Monitoring Heparin
Kelly A. Macedo (2018)
10.1161/CIRCOUTCOMES.119.005969
Real-World Adherence and Persistence to Direct Oral Anticoagulants in Patients With Atrial Fibrillation
Aya F. Ozaki (2020)
10.1161/CIRCRESAHA.116.306925
Evolving Treatments for Arterial and Venous Thrombosis: Role of the Direct Oral Anticoagulants.
N. Chan (2016)
10.1016/j.ejmech.2016.05.020
Design, synthesis, anticoagulant activity evaluation and molecular docking studies of a class of N-ethyl dabigatran derivatives.
Weixin Ren (2016)
10.1160/TH17-08-0568
Activated Factor X-Based versus Thrombin-Based Antithrombin Testing in Thrombophilia Workup in the DOAC Era.
H. Ruehl (2018)
10.1111/ijlh.12658
The danger of relying on the APTT and PT in patients on DOAC therapy, a potential patient safety issue
D. Adcock (2017)
10.5858/arpa.2020-0021-oa
The Effect of Direct Oral Anticoagulants on Antithrombin Activity Testing Is Abolished by DOAC-Stop in Venous Thromboembolism Patients.
M. Ząbczyk (2020)
10.1111/hae.12991
Quality laboratory issues in bleeding disorders
D. M. Adcock (2016)
Laboratory testing for Direct Oral Anticoagulants ( DOACs ) : Are we ready ?
Dr. Rock LEUNG (2017)
10.1038/nrdp.2018.20
Non-variceal upper gastrointestinal bleeding
Á. Lanas (2018)
10.1016/j.medcli.2016.09.022
Intracraneal hemorrhage during apixaban treatment.
Marc Sorigue (2017)
10.1002/14651858.CD012293
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing oral or dental procedures
Eveline T. Engelen (2016)
10.1080/09674845.2019.1605648
The rivaroxaban-adjusted normalized ratio: use of the prothrombin time to monitor the therapeutic effect of rivaroxaban
B. Kim (2019)
10.1111/ejh.13339
Clinical utility and impact of the use of the chromogenic vs one‐stage factor activity assays in haemophilia A and B
R. Marlar (2019)
10.1007/s40265-020-01345-5
Prevention and Treatment of Bleeding with Direct Oral Anticoagulants
R. Crawley (2020)
10.1002/ajh.25386
Purpura fulminans from reduced protein S following cytomegalovirus and varicella infection
L. K. Fonkoua (2019)
Use of direct oral anticoagulants in daily practice.
Feras M. Almarshad (2018)
10.1055/S-0038-1667872
Clinical pearls: Laboratory assessments of direct oral anticoagulants (DOACS)
Robert C Gosselin (2018)
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