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Cited by 17Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsAtrial Fibrillation Management and Outcomes

Impact of a Commercially Available DOAC Absorbent on Two Integrated Procedures for Lupus Anticoagulant Detection

Tripodi, Armando, Scalambrino, Erica, Chantarangkul, Veena, Paoletti, Oriana, Clerici, Marigrazia, Novembrino, Cristina, Boscolo-Anzoletti, Massimo, Peyvandi, Flora +1 more·2021·Thrombosis Research
DOI 10.1016/j.thromres.2021.06.001
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Abstract

Background Lupus anticoagulant (LA)-detection in anticoagulated patients is an unmet need, which becomes even more cogent with the introduction of direct oral anticoagulants (DOAC) that may lead to false-positive results. Aims We aimed to investigate the effect of a commercially available DOAC absorbent on residual drug concentrations, and on integrated procedures for LA-detection. Methods Blood from patients treated for atrial fibrillation with either dabigatran (n = 39), rivaroxaban (n = 55), apixaban (n = 47) or edoxaban (n = 47) were collected at peak and trough, and centralized for testing with two LA integrated procedures [i.e., the silica clotting time (SCT) and dilute Russel viper venom (dRVVT)] before and after DOAC absorbent exposure. Results The commercially available DOAC absorbent investigated in this study proved effective in reducing the concentrations of all the investigated DOAC, although small residual drug was detected after absorption, especially in patients on edoxaban. Results mimicking LA were observed in patients on DOAC before absorbent exposure, especially for rivaroxaban when testing was performed with dRVVT (88% rate at peak and 20% at trough) and much less with SCT (12% at peak and 8% at trough). The correspondent rate of results mimicking LA in patients on rivaroxaban after exposure was reduced [dRVVT (peak 8%, trough 4%); SCT (peak and trough 8%)], but not abolished. Conclusions Overall, in vitro DOAC absorbance by active charcoal compounds is a…

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Crossref · 10.1016/j.thromres.2021.06.001

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  • Both DOAC removal strategies (absorbents and filtration) can provide incomplete drug removal or influence the clotting times, resulting in possible false positives and false negatives in LA testing.

    “Both removal strategies can provide an incomplete drug removal or influence the clotting times, resulting in possible false positives and false negatives in LA testing [81,82,85,86].”

    From Lupus Anticoagulant Detection under the Magnifying Glass (2023) · cites this paper as [81]

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Authors
Tripodi, A., Scalambrino, E., Chantarangkul, V., Paoletti, O., Clerici, M., Novembrino, C., Boscolo-Anzoletti, M., Peyvandi, F., & Testa, S.
Affiliations
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
  • University of Milan (IT)
Corresponding author
Tripodi, Armando
ORCID
Venue
Thrombosis Research
Publisher
Elsevier BV
Published
2021-08
Volume
204
Pages
32-39
ISSN
0049-3848 (ISSN-L)
DOI
10.1016/j.thromres.2021.06.001
OpenAlex
W3166559372
Cited by
17
References
3
Citations by year
2026: 3 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 1
FWCI
2.46
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Thrombosis Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
lupus anticoagulant, direct oral anticoagulants, activated carbon, dabigatran, rivaroxaban, apixaban, edoxaban, atrial fibrillation, residual drug concentration, peak and trough drug levels
MeSH terms
Rivaroxaban, Dabigatran, Administration, Oral, Anticoagulants, Humans, Pyridones, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome

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