Abstract Number: PB0639
Meeting: ISTH 2020 Congress
Background: Common laboratory tests should not be used to monitor the anticoagulant effect of rivaroxaban (RIVA).
Aims: Thrombin generation assay (TGA) and calibrated anti-Factor X (anti-FXa) test were used to determine the effect of the RIVA 20 mg once-daily on coagulation in patients with venous thromboembolism (VTE).
Methods: Venous platelet-poor plasma (PPP) was obtained from 53 patients after 3 months of RIVA treatment. The first sample was collected 2 hours after drug ingestion (Cmax) and the second collected 30 minutes prior to the next dose (Ctrough). Control PPP was obtained from 178 healthy subjects without antithrombo-tics. Anti-FXa was measured using BIOPHEN® DiXal kit (Hyphen Biomed) and PT was tes-ted using Thromborel® S kit (Siemens Diagnostics) with BCS-XP® analyser (Siemens Diagnostics). TGA was determined using the kits for “thrombophilia tendency” testing (Technothrombin® TGA RC Low) and for “anticoagulant activity” testing (Technothrombin® TGA RC High) with Ceveron® alpha analyser (Technoclone). Results of the TGA were calculated for area under the curve (AUC). Paired t-test, Wilcoxon test and Pearson correlation test were used. Statistical significance was p˂0.05.
Results: AUC TGA RC Low and AUC TGA RC High in patients treated with RIVA were lower at Cmax and Ctrough than those in the control group (p< 0.001, all). Negative correlations (p< 0.05, all) were observed between anti-FXa with AUC TGA Low and with AUC TGA High at Cmax and at Ctrough, except the negative correlation between anti-FXa and AUC TGA RC High (r = – 0,251, p = 0.069, N.S.).
Conclusions: Once-daily 20 mg RIVA regimen is sufficient to decrease TG in patients with VTE in comparison with TG results in healthy persons. TGA (unlike anti-FXa) may be a useful tool for measuring inhibition of coagulation in patients receiving rivaroxaban for up to 24 hours.
To cite this abstract in AMA style:Kvasnicka J, Krska Z, Malikova I, Kvasnicka T. Rivaroxaban 20 mg Oce Daily Decreases Thrombin Generation in Patients with Venous Thromboembolism for up to 24 Hours [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/rivaroxaban-20-mg-oce-daily-decreases-thrombin-generation-in-patients-with-venous-thromboembolism-for-up-to-24-hours/. Accessed September 27, 2023.
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