2018
DOI: 10.1111/jth.13949
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Interlaboratory variability in the measurement of direct oral anticoagulants: results from the external quality assessment scheme

Abstract: Background Tests for direct oral anticoagulants (DOACs) are not widely available. The perception that they are difficult to perform and are subject to large between-laboratory variation makes their implementation difficult. Aims We carried out proficiency-testing surveys for DOACs within the activity of the external quality-assessment scheme of the Italian Federation of Thrombosis Centers. Design Participants were provided with coded freeze-dried plasmas without or with graded concentrations of the three main … Show more

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Cited by 25 publications
(27 citation statements)
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“…The remainder of the laboratories reported only the results from their routine clotting times for specimens containing DOACS. Relatively minimal between‐laboratory variability was observed with overall CVs of 8.7% for dabigatran, 8.4% for rivaroxaban, and 10.3% for apixaban measurement . It is unclear why the CVs observed in this study indicate less assay variability than was seen in the ECAT/NASCOLA study.…”
Section: Direct Oral Anticoagulantsmentioning
confidence: 56%
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“…The remainder of the laboratories reported only the results from their routine clotting times for specimens containing DOACS. Relatively minimal between‐laboratory variability was observed with overall CVs of 8.7% for dabigatran, 8.4% for rivaroxaban, and 10.3% for apixaban measurement . It is unclear why the CVs observed in this study indicate less assay variability than was seen in the ECAT/NASCOLA study.…”
Section: Direct Oral Anticoagulantsmentioning
confidence: 56%
“…Relatively minimal between-laboratory variability was observed with overall CVs of 8.7% for dabigatran, 8.4% for rivaroxaban, and 10.3% for apixaban measurement. 36 It is unclear why the CVs observed in this study indicate less assay variability than was seen in the ECAT/NASCOLA study. Results from RCPAQAP included 70 laboratories evaluating samples containing dabigatran and 44 laboratories evaluating samples that contained either rivaroxaban or apixaban.…”
Section: Irec Tor Alanti Coag Ul Antsmentioning
confidence: 67%
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“…As the PT and aPTT do not correlate consistently with therapeutic drug levels, they should not be used to interpret degree of anticoagulation with apixaban or rivaroxaban. [6][7][8][9][10] The anti-Xa assay (UFH/LMWH) is available at many institutions and can be used to rule out clinically significant anticoagulation to determine need for reversal. A normal result (less than 0.10 units/ml) provides reassurance that there is no clinically relevant FXai concentration, however long turnaround times may limit use in life-threatening bleeding.…”
Section: Coordinating Emergent Procedures After Andexanet Alfamentioning
confidence: 99%
“…Elevated values should be considered as a relative measure of activity and not interpreted in a linear fashion to represent drug concentration levels. [6][7][8][9][10] Importantly, standard clinical anti-Xa assays, such as Stago STA-Liquid Anti-FXa or HemosIL Liquid Anti-Xa, cannot be used to measure degree or efficacy of reversal during or after administration of andexanet alfa, as sample processing factors result in dissociation of andexanet alfa from FXai. 11…”
Section: Coordinating Emergent Procedures After Andexanet Alfamentioning
confidence: 99%