Interlaboratory variability of activated protein C resistance using the ETP-based APC resistance assay.

activated protein C resistance blood coagulation test contraceptive agents laboratories reproducibility of results

Journal

Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 20 07 2021
revised: 09 09 2021
accepted: 24 09 2021
entrez: 11 11 2021
pubmed: 12 11 2021
medline: 12 11 2021
Statut: epublish

Résumé

Although the endogenous thrombin potential (ETP)-based activated protein C (APC) resistance is recommended for the development of steroid contraceptive agents, one of the main limitations of this technique was its lack of standardization, which hampered study-to-study comparison. A validated methodology that meets all the regulatory requirements in terms of analytical performances has been developed recently. To ensure a wide implementation of this test, the assessment of the interlaboratory variability was needed. The assay was implemented in three testing laboratories. First, dose-response curves were performed to locally define APC concentration leading to 90% of ETP inhibition on healthy donors. Intra- and inter-run repeatability were assessed on a reference plasma and three quality controls. To investigate the variability in results among the different testing units, 60 donor samples were analyzed at each site. The APC concentration leading to 90% of ETP inhibition was defined at 1.21 µg/ml and 1.14 µg/ml in the two receiving units. Intra- and inter-run repeatability showed standard deviation below 3%. Analyses of the 60 donor samples showed no statistically significant difference. The sensitivity of the test in the different laboratories was maintained and subgroup analyses still reported significant differences depending on hormonal status of donors. This study is the first reporting the interlaboratory variability of the ETP-based APC resistance assay. Data revealed excellent intra- and interlaboratory reproducibility. These results support the concept that this blood coagulation test provides an appropriate sensitivity irrespective of the laboratory in which analyses are performed.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Although the endogenous thrombin potential (ETP)-based activated protein C (APC) resistance is recommended for the development of steroid contraceptive agents, one of the main limitations of this technique was its lack of standardization, which hampered study-to-study comparison. A validated methodology that meets all the regulatory requirements in terms of analytical performances has been developed recently. To ensure a wide implementation of this test, the assessment of the interlaboratory variability was needed.
METHOD METHODS
The assay was implemented in three testing laboratories. First, dose-response curves were performed to locally define APC concentration leading to 90% of ETP inhibition on healthy donors. Intra- and inter-run repeatability were assessed on a reference plasma and three quality controls. To investigate the variability in results among the different testing units, 60 donor samples were analyzed at each site.
RESULTS RESULTS
The APC concentration leading to 90% of ETP inhibition was defined at 1.21 µg/ml and 1.14 µg/ml in the two receiving units. Intra- and inter-run repeatability showed standard deviation below 3%. Analyses of the 60 donor samples showed no statistically significant difference. The sensitivity of the test in the different laboratories was maintained and subgroup analyses still reported significant differences depending on hormonal status of donors.
CONCLUSION CONCLUSIONS
This study is the first reporting the interlaboratory variability of the ETP-based APC resistance assay. Data revealed excellent intra- and interlaboratory reproducibility. These results support the concept that this blood coagulation test provides an appropriate sensitivity irrespective of the laboratory in which analyses are performed.

Identifiants

pubmed: 34761157
doi: 10.1002/rth2.12612
pii: S2475-0379(22)01469-8
pmc: PMC8563922
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e12612

Informations de copyright

© 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).

Références

Thromb Haemost. 1995 Mar;73(3):402-4
pubmed: 7667823
J Thromb Haemost. 2010 May;8(5):942-9
pubmed: 20096005
Res Pract Thromb Haemost. 2019 Jul 18;3(4):758-768
pubmed: 31624796
Br J Haematol. 2007 Oct;139(2):303-9
pubmed: 17897307
Thromb Res. 2015 Jul;136(1):125-30
pubmed: 25563679
Thromb Haemost. 2008 Apr;99(4):767-73
pubmed: 18392335
Clin Chem Lab Med. 2020 Jan 28;58(2):294-305
pubmed: 31444961
J Thromb Haemost. 2019 Aug;17(8):1273-1287
pubmed: 31063645
Blood Coagul Fibrinolysis. 1997 Jan;8(1):28-38
pubmed: 9105635
Blood Coagul Fibrinolysis. 1994 Oct;5(5):853-4
pubmed: 7865698
Thromb Res. 2012 May;129(5):e266-8
pubmed: 22475311
Br J Haematol. 1995 Oct;91(2):465-70
pubmed: 8547095
Thromb Res. 2012 Dec;130(6):929-34
pubmed: 22909826
Thromb Res. 2010 Apr;125(4):353-6
pubmed: 19942257
Br J Haematol. 1997 Apr;97(1):233-8
pubmed: 9136971

Auteurs

Laure Morimont (L)

Qualiblood sa Namur Belgium.
Faculty of Medicine Department of Pharmacy Namur Research Institute for Life Sciences (NARILIS) Namur Thrombosis and Hemostasis Center (NTHC) University of Namur Namur Belgium.

Marie Didembourg (M)

Faculty of Medicine Department of Pharmacy Namur Research Institute for Life Sciences (NARILIS) Namur Thrombosis and Hemostasis Center (NTHC) University of Namur Namur Belgium.

Hélène Haguet (H)

Qualiblood sa Namur Belgium.
Faculty of Medicine Department of Pharmacy Namur Research Institute for Life Sciences (NARILIS) Namur Thrombosis and Hemostasis Center (NTHC) University of Namur Namur Belgium.

Élise Modaffari (É)

Qualiblood sa Namur Belgium.

Maxence Tillier (M)

Service d'hématologie Biologique CHU Clermont-Ferrand Clermont-Ferrand France.

Céline Bouvy (C)

Qualiblood sa Namur Belgium.

Aurélien Lebreton (A)

Service d'hématologie Biologique CHU Clermont-Ferrand Clermont-Ferrand France.

Jean-Michel Dogné (JM)

Faculty of Medicine Department of Pharmacy Namur Research Institute for Life Sciences (NARILIS) Namur Thrombosis and Hemostasis Center (NTHC) University of Namur Namur Belgium.

Jonathan Douxfils (J)

Qualiblood sa Namur Belgium.
Faculty of Medicine Department of Pharmacy Namur Research Institute for Life Sciences (NARILIS) Namur Thrombosis and Hemostasis Center (NTHC) University of Namur Namur Belgium.

Classifications MeSH