Although direct oral anticoagulants do not require routine monitoring, specific tests such as dilute thrombin time, ecarin tests, and anti-factor Xa assays are recommended to measure drug concentrations in special clinical situations.
This consensus document provides practical guidance on the appropriate selection and interpretation of specific laboratory tests for measuring the anticoagulant effect of DOACs in special clinical situations.
Although direct oral anticoagulants (DOAC) do not require dose-adjustment on the basis of laboratory test results, the measurement of their anticoagulant effect is useful in special situations. This position paper issued by the Italian Scientific Societies that are mainly involved in the management of patients on DOAC is aimed at providing guidance to care-givers on which tests should be used and the situations in which testing is useful. The guidance is based on the data from the literature so far available and/or on consensus among experts.
Tripodi et al. (Sat,) conducted a review in Patients on direct oral anticoagulants. Laboratory testing for direct oral anticoagulants was evaluated. Although direct oral anticoagulants do not require routine monitoring, specific tests such as dilute thrombin time, ecarin tests, and anti-factor Xa assays are recommended to measure drug concentrations in special clinical situations.