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Cited by 46Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsAtrial Fibrillation Management and Outcomes

Effects of Direct Oral Anticoagulants on Lupus Anticoagulant Assays in a Real-Life Setting

Antovic, Aleksandra, Norberg, Eva-Marie, Berndtsson, Maria, Rasmuson, Agnes, Malmström, Rickard E., Skeppholm, Mika, Antovic, Jovan·2017·Thrombosis and Haemostasis
DOI 10.1160/th17-03-0204
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Abstract

Laboratory diagnosis of lupus anticoagulant (LA) is based on prolongation in at least one coagulation assay (diluted Russell's viper venom time - dRVVT or activated partial thromboplastin time - aPTT), which normalises after addition of phospholipids. Both assays may be influenced by anticoagulants and therefore LA should not be tested during warfarin or heparin treatment. It has been shown (primarily in vitro) that direct oral anticoagulants (DOACs - dabigatran [DAB], rivaroxaban [RIV] and apixaban [API]) may also influence LA testing. We tested the effects of DOACs on assays routinely used for the diagnosis of LA in patients treated with these drugs in a real-life setting. Plasma from patients with atrial fibrillation treated with DAB (n=30), RIV (n=20) and API (n=17) and not known to have LA were tested using dRVVT (LA-screen and LA-confirm, Life Diagnostics) and aPTT (PTT-LA, Diagnostica Stago and aPTT Actin FS, Siemens Healthcare Diagnostics) assays. According to the diagnostics algorithm, dRVVT and aPTT ratios of 1.4 positive, while if the ratios were 1.2-1.4 LA could not be ruled out. Plasma concentrations varied between 8-172 µg/l for DAB, 8-437 µg/l for RIV and 36-178 µg/l for API. LA diagnosis was negative in only eight (27 %) plasma samples from patients treated with DAB, and in five (25 %) and four samples (24 %) from patients treated with RIV and API, respectively. LA Positivity (dRVVT and aPTT ratios >1.4) was found in 5 cases (17 %) among patients treated with…

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  • All DOACs prolong dRVVT in screening and confirmatory procedures, with rivaroxaban affecting screening more than confirmatory (increasing potential false positives) and opposite apixaban action (increasing potential false negatives).

    “all DOACs prolong dRVVT in screening and confirmatory procedures, with rivaroxaban affecting screening more than confirmatory (increasing potential false positives) and opposite apixaban action (increasing potential false negatives) [73,74,75,76,77,78].”

    From Lupus Anticoagulant Detection under the Magnifying Glass (2023) · cites this paper as [78]

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Authors
Antovic, A., Norberg, E.-M., Berndtsson, M., Rasmuson, A., Malmström, R. E., Skeppholm, M., & Antovic, J.
Affiliations
  • Karolinska University Hospital (SE)
  • Danderyds sjukhus (SE)
ORCID
Venue
Thrombosis and Haemostasis
Publisher
Georg Thieme Verlag KG
Published
2017
Volume
117
Issue
09
Pages
1700-1704
ISSN
  • 0340-6245 (ISSN-L)
  • 2567-689X
DOI
10.1160/th17-03-0204
OpenAlex
W2649415550
Cited by
46
References
3
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 7 · 2019: 12 · 2018: 7
FWCI
6.21
Type
journal article
Language
en
Open access
closed
Locations
  • Thrombosis and Haemostasis (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, dabigatran, rivaroxaban, apixaban, dilute Russell's viper venom time, activated partial thromboplastin time, atrial fibrillation, anticoagulation
MeSH terms
Rivaroxaban, Dabigatran, Administration, Oral, Anticoagulants, Atrial Fibrillation, Blood Coagulation, Dose-Response Relationship, Drug, False Positive Reactions, Humans, Partial Thromboplastin Time, Predictive Value of Tests, Prothrombin Time, Pyrazoles, Pyridones, Reproducibility of Results, Biomarkers, Lupus Coagulation Inhibitor, Drug Monitoring

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