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Betrixaban: Impact on Routine and Specific Coagulation Assays-A Practical Laboratory Guide
Romain Siriez1, Jonathan Evrard1, Jean-Michel Dogné1
1University of Namur, Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for LIfe Sciences (NARILIS), Namur, Belgium.
Thrombosis and Haemostasis
|June 12, 2018
Summary
Adapted chromogenic anti-Xa assays are best for measuring betrixaban concentration. Betrixaban impacts routine coagulation tests, requiring careful interpretation in clinical practice.
Area of Science:
- Pharmacology
- Clinical Coagulation
- Laboratory Medicine
Background:
- Betrixaban is a direct oral factor Xa inhibitor for venous thromboembolism prophylaxis.
- Assessing betrixaban's anticoagulant effect and its impact on routine tests is clinically relevant.
Purpose of the Study:
- To identify optimal coagulation assays for betrixaban impact assessment.
- To provide laboratory guidance for interpreting these assays.
Main Methods:
- Betrixaban was added to platelet-poor plasma at various concentrations.
- Impact on pro-thrombin time (PT), activated partial thromboplastin time (aPTT), dilute Russel viper venom time (dRVV-T), chromogenic anti-Xa assays, and thrombin generation assay (TGA) was evaluated.
Main Results:
- Betrixaban caused concentration-dependent prolongation of aPTT, PT, and dRVV-T, with reagent-dependent sensitivity.
- Chromogenic anti-Xa assays showed high sensitivity but required adaptation for betrixaban measurement.
- Thrombin generation assay (TGA) also showed potential for assessing betrixaban's activity.
Conclusions:
- Adapted chromogenic anti-Xa assays are most suitable for estimating betrixaban concentration.
- Clinicians must consider betrixaban's significant effect on multiple hemostasis tests during interpretation.
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