Direct oral anticoagulants impact routine and specialty laboratory assays, necessitating the use of drug-specific assays or alternative methods to determine relative drug concentration.
This review details the impact of direct oral anticoagulants on routine and specialty laboratory assays, including methods for determining relative drug concentrations.
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.
Adcock et al. (2015) conducted a review in Anticoagulation therapy. Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists (warfarin) was evaluated. Direct oral anticoagulants impact routine and specialty laboratory assays, necessitating the use of drug-specific assays or alternative methods to determine relative drug concentration.