Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians

  title={Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians},
  author={Jonathan Douxfils and Walter Ageno and Charles Marc Samama and Sarah Lessire and Hugo ten Cate and Peter Verhamme and Jean Michel Dogn{\'e} and François Mullier},
  journal={Journal of Thrombosis and Haemostasis},
  pages={19 - 209}
Click to hear Dr Baglin's perspective on the role of the laboratory in treatment with new oral anticoagulants 
A New Test for the Detection of Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in the Emergency Room Setting
This research presents a novel probabilistic approach that allows us to assess the importance of knowing the carrier and removal status of canine coronavirus as a source of infection for other animals.
Direct oral anticoagulants: When to consider laboratory testing?
Dose adjustment based on laboratory testing is not required; however, there are several potential situations that deserve insight into a DOAC plasma activity level.
Direct Oral Anticoagulant removal by a DOAC filter: Impact on lupus anticoagulant testing – Evaluation on spiked and patient samples
DOAC Filter (DF) is a new device to overcome interference in lupus anticoagulant (LAC) testing by direct oral anticoagulants (DOACs).
DOAC‐Stop in lupus anticoagulant testing: Direct oral anticoagulant interference removed in most samples
DOACs interfere with clot‐based testing for the identification of lupus anticoagulant antibodies in patients with antiphospholipid syndrome, a common cause of acquired thrombotic disease.
Direct oral anticoagulant adsorption: Impact on lupus anticoagulant testing—Review of the literature and evaluation on spiked and patient samples
DOAC‐Stop (D‐S) represents a preanalytical strategy to cope with this issue of direct oral anticoagulant interference with lupus anticoAGulant testing.
Resolving DOAC interference on aPTT, PT, and lupus anticoagulant testing by the use of activated carbon
Direct oral anticoagulants (DOACs) affect laboratory coagulations tests. Activated carbon (AC) can be used for adsorption of DOACs during acute human intoxications.
Anti–factor Xa activity assays of direct‐acting oral anticoagulants during clinical care: An observational study
Direct‐acting oral anticoagulants (DOACs) are increasingly used to prevent and treat thromboembolism. Although measurement of DOAC concentrations is not currently recommended as part of routine
Inter‐ and intra‐individual concentrations of direct oral anticoagulants: The KIDOAC study
Direct oral anticoagulants (DOACs) do not require concentration monitoring. However, whether DOAC concentrations are stable and their variation between and within patients is not well studied.
Measurement of apixaban concentrations in real‑world clinical and laboratory settings: the first Polish experience.
The objective was to establish an experimental procedure to establish a baseline for the determination of the intensity of the response of the responders to the noise level in the experimental setting.
Drug levels and bleeding complications in atrial fibrillation patients treated with direct oral anticoagulants
The need of a more accurate DOAC dose assessment is suggested, as patients who developed bleeding events showed higher DOAC plasma levels at peak.


Poor comparability of coagulation screening test with specific measurement in patients receiving direct oral anticoagulants: results from a multicenter/multiplatform study
PT, PTT and specific tests for DOACs were performed on patients treated for atrial fibrillation to measure direct oral anticoagulant action.
An optimised, rapid chromogenic assay, specific for measuring direct factor Xa inhibitors (rivaroxaban) in plasma.
An optimised, rapid chromogenic assay, specific for measuring direct factor Xa inhibitors (rivaroxaban) in plasma -
Clinical pearls: Laboratory assessments of direct oral anticoagulants (DOACS).
Clinical Pearls for DOAC assessment using common and esoteric coagulation testing is described and it is suggested that the clinical laboratory should have an algorithmic testing plan for adequately assessing the presence of all DOACS.
The laboratory's 2015 perspective on direct oral anticoagulant testing
It is demonstrated that reagent sensitivity varies significantly whether drug‐spiked samples or samples from DOAC‐treated patients are tested, and laboratory assays that can be used to determine drug presence and to measure drug concentration are presented, and recommended testing algorithms are provided.
Oral anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
There is a large amount of evidence on laboratory and clinical characteristics of vitamin K antagonists and a growing body of evidence is becoming available on the first new oral anticoagulant drugs available for clinical use, dabigatran and rivaroxaban.
Comparison of the effect of the anti‐Xa direct oral anticoagulants apixaban, edoxaban, and rivaroxaban on coagulation assays
The purpose of this study is to compare the effect of increasing concentrations of direct anti‐Xa oral anticoagulants (DOAC) apixaban‐, edoxaban‐, and rivaroxaban‐enriched plasma samples on various
To measure or not to measure direct oral anticoagulants before surgery or invasive procedures: comment
The effect of different dabigatran concentrations on the APTT is studied, using six different APTT reagents and performed on three coagulation analyzer platforms.
Laboratory Monitoring of Non–Vitamin K Antagonist Oral Anticoagulant Use in Patients With Atrial Fibrillation: A Review
Robust evidence from patients with atrial fibrillation randomized to NOACs or warfarin demonstrates that unmonitored NOAC therapy is at least as effective and safe as monitored warfarins, with lower rates of intracranial hemorrhage and reduced mortality.
Laboratory measurement of the direct oral anticoagulants: Indications and impact on management in clinical practice
In conclusion, DOAC measurement was infrequently requested and differed between hospitalized patients and outpatients, and clinical response varied by drug level and indication.