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Effects of the oral, direct factor Xa inhibitor rivaroxaban on commonly used coagulation assays
University and Reg Labs Reg Scania.
Sahlgrens University Hospital.
University of Gothenburg.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
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2011 (English)In: JOURNAL OF THROMBOSIS AND HAEMOSTASIS, ISSN 1538-7933, Vol. 9, no 1, 133-139 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Rivaroxaban is an oral direct factor Xa inhibitor developed for prophylaxis and treatment of thromboembolic disorders. Laboratory monitoring is not necessary but the dose-dependent effects on common reagents and assay procedures are largely unknown. Objectives: To investigate the effect of rivaroxaban on commonly used coagulation assays. Materials and Methods: Rivaroxaban was added to plasma from healthy subjects in the concentration range 0-1000 mu g L-1 and analyzed using different reagents for activated partial thromboplastin time (APTT), prothrombin time (PT), antithrombin, fibrinogen and activated protein C (APC) resistance assays. Results: At an expected peak concentration of rivaroxaban in clinical use, the APTTs were almost invariably prolonged but at lower concentrations the effect was weak. The concentration needed to double the APTT varied between 389 +/- 106 and 617 +/- 149 mu g L-1 for different reagents. The PT assays showed a marked degree of difference. In general, the Quick PT type assays were more sensitive compared with the Owren type PT assays. The results from antithrombin assays were dependent on the type of reagent, with the Xa-based assay being sensitive for rivaroxaban with an estimated increase of 0.09 IU mL-1 per 100 mu g L-1 rivaroxaban. There were only minor effects on fibrinogen assays based on thrombin reagents. The APTT-based assay for APC resistance is affected in a dose-dependent manner whereas an assay based on the activation of coagulation at the prothrombinase level was unaffected. Conclusions: Different assays, and even different reagents within an assay group, display variable effects by therapeutic concentrations of rivaroxaban.

Place, publisher, year, edition, pages
Blackwell Publishing , 2011. Vol. 9, no 1, 133-139 p.
Keyword [en]
anticoagulants, coagulation assays, direct Xa inhibitor, rivaroxaban
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-66866DOI: 10.1111/j.1538-7836.2010.04098.xISI: 000286055500019OAI: diva2:405316
This is the authors’ version of the following article: A Hillarp, F Baghaei, I Fagerberg Blixter, K M Gustafsson, L Stigendal, M Sten-Linder, K Strandberg and Tomas Lindahl, Effects of the oral, direct factor Xa inhibitor rivaroxaban on commonly used coagulation assays, 2011, JOURNAL OF THROMBOSIS AND HAEMOSTASIS, (9), 1, 133-139. which has been published in final form at: Copyright: Blackwell Publishing Available from: 2011-03-22 Created: 2011-03-21 Last updated: 2011-03-31

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