TY - JOUR
T1 - Influence of apixaban on commonly used coagulation assays
T2 - results from the Belgian national External Quality Assessment Scheme
AU - Van Blerk, M
AU - Bailleul, E
AU - Chatelain, B
AU - Demulder, A
AU - Devreese, K
AU - Douxfils, J
AU - Jacquemin, M
AU - Jochmans, K
AU - Mullier, F
AU - Wijns, W
AU - China, B
AU - Vernelen, K
AU - Soumali, M R
N1 - © 2017 John Wiley & Sons Ltd.
PY - 2017/8
Y1 - 2017/8
N2 - INTRODUCTION: The Belgian national External Quality Assessment Scheme performed a survey to assess the effect of the direct oral anticoagulant apixaban on the coagulation assays prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and antithrombin as performed with a large number of reagent/instrument combinations.METHODS: Four lyophilized plasma samples spiked with apixaban (0, 41, 94 and 225 ng/mL) were sent to the 195 Belgian and Luxembourg clinical laboratories performing coagulation testing.RESULTS: PT and aPTT were barely influenced at the concentrations tested. At 225 ng/mL apixaban, PT and aPTT clotting times were only 1.15 times longer than at 0 ng/mL. Among PT reagents, RecombiPlasTin 2G(®) showed a slightly higher sensitivity with 225 ng/mL apixaban prolonging the PT clotting time 1.3-fold. Among aPTT reagents, there was no appreciable difference in sensitivity. Fibrinogen results were unaffected by the presence of apixaban, but antithrombin activity was considerably overestimated when measured with a FXa-based assay. At 225 ng/mL apixaban, the median percentage increase in antithrombin level was 31% when measured with the Liquid Antithrombin(®) reagent and 44% with the Innovance Antithrombin(®) reagent.CONCLUSION: Our data provide clinical laboratories with useful information on the impact of apixaban on their routine coagulation assays.
AB - INTRODUCTION: The Belgian national External Quality Assessment Scheme performed a survey to assess the effect of the direct oral anticoagulant apixaban on the coagulation assays prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and antithrombin as performed with a large number of reagent/instrument combinations.METHODS: Four lyophilized plasma samples spiked with apixaban (0, 41, 94 and 225 ng/mL) were sent to the 195 Belgian and Luxembourg clinical laboratories performing coagulation testing.RESULTS: PT and aPTT were barely influenced at the concentrations tested. At 225 ng/mL apixaban, PT and aPTT clotting times were only 1.15 times longer than at 0 ng/mL. Among PT reagents, RecombiPlasTin 2G(®) showed a slightly higher sensitivity with 225 ng/mL apixaban prolonging the PT clotting time 1.3-fold. Among aPTT reagents, there was no appreciable difference in sensitivity. Fibrinogen results were unaffected by the presence of apixaban, but antithrombin activity was considerably overestimated when measured with a FXa-based assay. At 225 ng/mL apixaban, the median percentage increase in antithrombin level was 31% when measured with the Liquid Antithrombin(®) reagent and 44% with the Innovance Antithrombin(®) reagent.CONCLUSION: Our data provide clinical laboratories with useful information on the impact of apixaban on their routine coagulation assays.
KW - Antithrombins/blood
KW - Belgium
KW - Blood Coagulation Tests/methods
KW - Blood Coagulation/drug effects
KW - Drug Monitoring
KW - Factor Xa Inhibitors/pharmacology
KW - Fibrinogen/biosynthesis
KW - Humans
KW - Partial Thromboplastin Time
KW - Prothrombin Time
KW - Pyrazoles/pharmacology
KW - Pyridones/pharmacology
KW - Quality Assurance, Health Care
UR - http://www.scopus.com/inward/record.url?scp=85021662847&partnerID=8YFLogxK
U2 - 10.1111/ijlh.12640
DO - 10.1111/ijlh.12640
M3 - Article
C2 - 28304137
VL - 39
SP - 402
EP - 408
JO - International Journal of Laboratory Hematology
JF - International Journal of Laboratory Hematology
SN - 1751-5521
IS - 4
ER -