Laboratory measurement of the direct oral anticoagulants

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The laboratory and the direct oral anticoagulants.

Although direct oral anticoagulants do not need laboratory testing for dose adjustment, there are instances when laboratory measurement of the drug anticoagulant effect may be useful. They include before initiation of treatment, before surgical or invasive procedures, on the occasion of hemorrhagic or thrombotic events, and whenever immediate reversal of anticoagulation is needed. Choice of tes...

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Laboratory Monitoring of Direct Oral Anticoagulants

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Blood Spotlight The laboratory and the direct oral anticoagulants

The direct oral anticoagulants (DOAC), which include the thrombin inhibitor dabigatran and the anti-Xa agents rivaroxaban, apixaban, and edoxaban, are in clinical use in many countries (Figure 1). Clinical trials have shown that DOAC, unlike vitamin K antagonists (VKA), are effective and safe when administered without dose adjustment based on laboratory testing. However, it is a misconception t...

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Reversal of direct oral anticoagulants

Reversal agents for direct oral anticoagulants (DOACs), including factor X inhibitors and direct thrombin inhibitors, are a major concern in clinical practice. After DOACs were introduced and became widely used as an alternative for vitamin K antagonists in the management of venous thromboembolism and nonvalvular atrial fibrillation, the need for effective reversal agents has increased, particu...

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The laboratory and the new oral anticoagulants.

BACKGROUND The new oral anticoagulants (NOAs) dabigatran, rivaroxaban, and apixaban have proved effective and safe when used in clinical trials, without a need to adjust the dose in response to laboratory testing. This demonstrated efficacy does not necessarily mean that the laboratory, considered the mainstay for the management of the old anticoagulants, will no longer play a role in treatment...

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ژورنال

عنوان ژورنال: British Journal of Haematology

سال: 2015

ISSN: 0007-1048

DOI: 10.1111/bjh.13810