Monitoring Direct Oral Anticoagulants: Longing for the Days When We Were in Control?

Laboratory Monitoring of Direct Oral Anticoagulants

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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...

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...

Bleeding complications from the direct oral anticoagulants

BACKGROUND Direct oral anticoagulants (DOACs) are now standard of care for the management of thromboembolic risk. A prevalent issue of concern is how to manage direct oral anticoagulant (DOAC)-associated bleeding for which there is no specific antidote available for clinical use. We conducted a retrospective case series to describe the Toronto, Canada multicenter experience with bleeding from d...

Laboratory monitoring of warfarin in the era of direct oral anticoagulants.