Abstract Number: PB1066
Meeting: ISTH 2021 Congress
Background: The effect of direct oral anticoagulants (DOAC) on laboratory tests dependent on the production of their targets, factor IIa and factor Xa (FXa), is a well-known problem and can cause both false positive and negative results. In particular, the situation in patients who develop lupus anticoagulant (LA) antibodies is very complex.
Aims: For evaluating the effectiveness of DOAC therapy at lupus positive patiens, 35 samples were enrolled. All patient samples were spiked by free types of DOACs (dabigatran etixilate, rivaroxaban and apixaban) in concentration that significantly influenced screening test fo lupus anticoagulans and thus so can mask the presence of LA. Subsequently, the DOAC was always unbound by the DOAC-STOP procedure. DOAC levels before and after binding were determined by functional assays followed by HPLC MS / MS.
Methods: Determination of DOAC levels was performed by specific functional tests – dabigatran – direct thrombin assay and xabans – determination of anti Xa activity with specific calibration. Our in house LC-MS/MS method enables simultaneous determination of apixaban, dabigatran and rivaroxaban.
Results: The results of LA positive samples show significant differences between functional tests and HPLC MS / MS method both before and after DOAC binding.
Conclusions: The severe finding of the presence of LA-type antibodies fundamentally affects the determination of DOAC by functional tests, and in this case it is necessary to use HPLC MS / MS analysis to determine the true value.
If patients treated with DOAC develop LA of medium and higher titers, we do not recommend checking with functional tests.
Supported by grant LF-2021-001 and MH CZ – DRO (FNOl, 00098892)
To cite this abstract in AMA style:
Slavik L, Jacova J, Friedecky D, Ulehlova J, Bradacova P, Skoumalova A, Prochazkova J, Hlusi A, Palova M, Kvasnička A, Ivanovova E, Pisklakova B. Evaluation of the Determination of Dabigatran, Rivaroxaban, and Apixaban at Lupus Anticoagulans Positive Patients [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/evaluation-of-the-determination-of-dabigatran-rivaroxaban-and-apixaban-at-lupus-anticoagulans-positive-patients/. Accessed March 22, 2024.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/evaluation-of-the-determination-of-dabigatran-rivaroxaban-and-apixaban-at-lupus-anticoagulans-positive-patients/