Lupus anticoagulant diagnosis in patients receiving direct oral FXa inhibitors at trough levels: A real-life study.
Administration, Oral
Antiphospholipid Syndrome
/ blood
Blood Coagulation Tests
/ methods
Factor Xa Inhibitors
/ administration & dosage
False Positive Reactions
Humans
Lupus Coagulation Inhibitor
/ blood
Partial Thromboplastin Time
Pyrazoles
/ pharmacology
Pyridones
/ pharmacology
Rivaroxaban
/ pharmacology
activated partial thromboplastin time
apixaban
dilute russell viper venom time
direct oral anticoagulant
rivaroxaban
Journal
International journal of laboratory hematology
ISSN: 1751-553X
Titre abrégé: Int J Lab Hematol
Pays: England
ID NLM: 101300213
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
12
06
2019
revised:
05
08
2019
accepted:
12
08
2019
pubmed:
6
9
2019
medline:
3
4
2020
entrez:
6
9
2019
Statut:
ppublish
Résumé
Direct oral factor Xa inhibitors (xabans) induce false positive results for lupus anticoagulant (LA) diagnosis. Consequently, it is suggested not to perform LA testing in xabans patients although it may be useful in selected patients. In this monocentric study, we evaluated xabans impact at trough levels (ie, just before the next intake) on LA diagnosis in treated patients using dilute Russell viper venom time (dRVVT) and two LA sensitive activated partial thromboplastin time (aPTT). Sixty patients receiving rivaroxaban (30) or apixaban (30) were included. Plasma concentrations were measured using specific anti-Xa assays. LA testing was performed using one dRVVT (LAC-Screening Median [min-max] concentrations were 23 [<18-68] for rivaroxaban and 42 ng/mL [19-99] for apixaban. dRVVT was positive in 93% of rivaroxaban and 40% of apixaban samples. SCT was positive in 40 and 30% and Actin F in 17 and 20% of samples respectively. Xabans affected more significantly dRVVT than aPTT-based assays (P < .001) with less false positive results with apixaban than with rivaroxaban samples irrespective of the assay used. lupus anticoagulant diagnosis in rivaroxaban and apixaban samples drawn at trough levels remains questionable whenever positive results are obtained. If LA testing in apixaban samples might be useful to rule-out LA using dRVVT and/or aPTT-based assays, the wide majority of rivaroxaban samples would give false positive results.
Substances chimiques
Factor Xa Inhibitors
0
Lupus Coagulation Inhibitor
0
Pyrazoles
0
Pyridones
0
apixaban
3Z9Y7UWC1J
Rivaroxaban
9NDF7JZ4M3
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
738-744Informations de copyright
© 2019 John Wiley & Sons Ltd.
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