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Influence of DOAC Stop on coagulation assays in samples from patients on rivaroxaban or apixaban

Sean Platton1, Christina Hunt2

  • 1The Royal London Hospital Haemophilia Centre, Barts Health NHS Trust, The Royal London Hospital, London, UK.

International Journal of Laboratory Hematology
|November 24, 2018
PubMed

Insights

DOAC Stop effectively removes direct oral anticoagulant (DOAC) interference in clotting tests for rivaroxaban and apixaban. This aids in accurate laboratory screening for coagulopathy and lupus anticoagulants in treated patients.

Area of Science:

  • Hematology
  • Clinical Chemistry
  • Pharmacology

Background:

  • Direct oral anticoagulants (DOACs) are widely used but interfere with laboratory coagulation assays.
  • Accurate interpretation of hemostasis tests in patients on DOACs is challenging due to variable drug interference.
  • DOAC Stop is a novel agent designed to adsorb DOACs from plasma samples.

Purpose of the Study:

  • To evaluate the efficacy of DOAC Stop in removing the interference of rivaroxaban and apixaban on various hemostasis assays.
  • To assess if DOAC Stop enables more accurate interpretation of coagulation tests in patients treated with these DOACs.

Main Methods:

  • Plasma samples from patients on rivaroxaban, apixaban, or no anticoagulant were analyzed.
  • Standard coagulation tests including PT, APTT, anti-Xa assay, factor VIII assays, and DRVVT were performed.
  • Tests were conducted before and after sample treatment with DOAC Stop.

Main Results:

  • DOAC Stop significantly reversed the effects of rivaroxaban and apixaban on PT, APTT, anti-Xa activity, factor VIII, and DRVVT assays.
  • The reagent reduced false positive lupus anticoagulant interpretations in patients on rivaroxaban.
  • No impact on results was observed in non-anticoagulated patient samples.

Conclusions:

  • DOAC Stop shows promise for laboratory screening of coagulopathy and lupus anticoagulants in patients on rivaroxaban or apixaban.
  • Careful interpretation is advised as complete reversal of anti-Xa effects was not universally achieved.
Abstract

Keywords:
anticoagulantsdrug effectsfactor VIIIlaboratory practicelupus inhibitor

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