Influence of apixaban on commonly used coagulation assays: results from the Belgian national External Quality Assessment Scheme

M Van Blerk, E Bailleul, B Chatelain, A Demulder, K Devreese, J Douxfils, M Jacquemin, K Jochmans, F Mullier, W Wijns, B China, K Vernelen, M R Soumali

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19 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)402-408
Number of pages7
JournalInternational Journal of Laboratory Hematology
Issue number4
Publication statusPublished - Aug 2017


  • Antithrombins/blood
  • Belgium
  • Blood Coagulation Tests/methods
  • Blood Coagulation/drug effects
  • Drug Monitoring
  • Factor Xa Inhibitors/pharmacology
  • Fibrinogen/biosynthesis
  • Humans
  • Partial Thromboplastin Time
  • Prothrombin Time
  • Pyrazoles/pharmacology
  • Pyridones/pharmacology
  • Quality Assurance, Health Care


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