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Effects of the oral, direct factor Xa inhibitor edoxaban on routine coagulation assays, lupus anticoagulant and anti-Xa assays
Halland Cty Hosp, Sweden.
Univ and Reg Labs Reg Skane, Sweden.
Sahlgrens Univ Hosp, Sweden.
Univ Gothenburg, Sweden.
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2018 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 78, no 7-8, p. 575-583Article in journal (Refereed) Published
Abstract [en]

Edoxaban is an oral direct factor Xa inhibitor for prophylaxis and treatment of thromboembolic disorders. The effects on common coagulation assays are clinically valuable information and in certain clinical situations a quick assessment of the anticoagulant is wanted. Our aim was to investigate the effect of edoxaban on routine coagulation methods and evaluate anti-Xa assays, commonly used for other direct factor Xa inhibitors, for estimation of the drug concentration. Edoxaban was spiked to plasma samples from healthy subjects in the concentration range 0-742 mu g/L and analyzed using different reagents for activated partial thromboplastin time (APTT) and prothrombin time (PT). Assays for antithrombin, activated protein C resistance, lupus anticoagulant (LA) and chromogenic anti-Xa assays were also included. Edoxaban displayed similar effects in vitro to other oral direct Xa inhibitors. The concentration needed to double the coagulation time varied between assays and reagents; 539-758 mu g/L for the APTT and between 329 and 2505 mu g/L for the PT. Edoxaban gave false high antithrombin activities in assays based on Xa-inhibition. Two integrated assays for LA, both based on activation with dilute Russells viper venom, displayed different results. Chromogenic anti-Xa assays displayed linear dose-response curves with edoxaban up to approximately 500 mu g/L. In conclusion, therapeutic concentrations of edoxaban variably affect different coagulation assays, and even different reagents within an assay group. In comparison with other oral Xa-inhibitors, the in vitro effects of edoxaban were more similar to rivaroxaban than apixaban. For measurement of edoxaban concentration in plasma, it is possible to use the chromogenic anti-Xa assays.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2018. Vol. 78, no 7-8, p. 575-583
Keywords [en]
Anticoagulants; blood coagulation analysis; edoxaban; lupus coagulation inhibitor; activated partial thromboplastin time; prothrombin time
National Category
Clinical Laboratory Medicine
Identifiers
URN: urn:nbn:se:liu:diva-153979DOI: 10.1080/00365513.2018.1522664ISI: 000454770900009PubMedID: 30278787OAI: oai:DiVA.org:liu-153979DiVA, id: diva2:1281109
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-05-02

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Gustafsson, Kerstin

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Gustafsson, KerstinLindahl, Tomas
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Division of Microbiology and Molecular MedicineFaculty of Medicine and Health SciencesDepartment of Clinical Chemistry
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Scandinavian Journal of Clinical and Laboratory Investigation
Clinical Laboratory Medicine

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