Effect of Edoxaban on Laboratory Methods

H. von Horn^1,2, L. Bui³, A. Rasmuson^1,2, J. Douxfils⁴, J. Harenberg^5,6, J. Antovic^1,2, K. Christensen³

¹Division of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden, ²Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, ³Department of Clinical Chemistry Central Hospital Karlstad, Karlstad, Sweden, ⁴University of Namur, Department of Pharmacy, Namur, Belgium, ⁵Heidelberg University, Heidelberg, Germany, ⁶DOASENSE GmbH, Heidelberg, Germany

Abstract Number: PB0392

Meeting: ISTH 2021 Congress

Theme: Diagnostics and OMICs » Laboratory Diagnostics

Background: Direct acting oral anticoagulants (DOACs) are increasingly prescribed. Routine determination of DOACs is not considered necessary in general but may be required in the acute medical setting to rule out significant drug concentration. The prescription of edoxaban is expected to increase in patients with active cancer treated with anticoagulants due to atrial fibrillation.

Aims: We aim to investigate the effect of edoxaban in a real life setting on laboratory assays to rule out significant drug concentration with short turn-around time, including point of care tests.

Methods: A prospective consecutive study was performed in 50 patients treated with 30 mg or 60 mg od edoxaban at the anticoagulation clinic at Karlstad Central Hospital, Sweden, and blood and urine samples were taken at different times of the day at trough or peak levels of edoxaban. Plasma and urine samples were sent to the Karolinska University Laboratory for analyses of edoxaban concentration by chromogenic anti-factor Xa method and to the University of Namur to measure edoxaban concentration by liquid chromatography tandem mass spectrometry (LC-MS/MS). The POCT DOAC Dipstick (DOASENSE GmbH) was used to rule out drug concentration in patients’ urine samples by visual and DOASENSE Reader analysis. Plasma concentration were compared to urine concentrations and quantitative results were dichotomized to compare with results from qualitative methods. Turnaround times for laboratory analysis of DOACs methods were compared. The study was approved by the local ethics committee and adheres to the declaration of Helsinki.

Results: To date, the first 10 patients have been included. The complete inclusion (or study) will be done by the end of June 2021.

Conclusions: The result of this study will generate reliable information on the metabolism of edoxaban and on rapid and accurate exclusion of significant amount of active edoxaban before acute interventions to avoid bleeding or to accelerate medical decision-making in major bleed.

To cite this abstract in AMA style:

von Horn H, Bui L, Rasmuson A, Douxfils J, Harenberg J, Antovic J, Christensen K. Effect of Edoxaban on Laboratory Methods [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/effect-of-edoxaban-on-laboratory-methods/. Accessed January 23, 2022.

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