Oct 23 2026

george

Can We Confirm a DOAC Overdose?

Here’s a provocative question from Sacha N. Uljon, MD, PhD, Medical Director, Massachusetts General Brigham Special Coagulation Integrated Laboratory Service: Hello, this post is about lab findings in apixaban overdose. We have now seen two suicide attempts involving apixaban. There was no clot at all on the PT/PTT (Werfen/Hemosil), so the anti-Xa level can’t be […]

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Anticoagulant Therapy

Oct 20 2026

george

Reduced-dose DOACs in Cancer-associated Thrombosis

Click for this open-access retrospective cohort study reporting the safety and efficacy outcomes for reduced-dose DOACS: Santini P, Santagata D, Mosoni C, et al. Full- versus reduced-dose direct oral anticoagulants for extended treatment of cancer-associated thrombosis: a multicenter retrospective cohort study. Semin Thromb Hemost. 2026. doi: 10.1055/a-2904-5824. PMID: 42379243. Abstract Extended anticoagulation is recommended in […]

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Anticoagulant Therapy

Oct 12 2026

george

Heparin Effect on Chemiluminescence HIT Testing

Check with your local library for this HIT testing report: Vong R, Pasalic L, Donikian D, Brighton T, Favaloro EJ. Effect of heparin on immunological heparin-induced thrombocytopenia-IgG chemiluminescence testing. Blood Coagul Fibrinolysis. 20261;37(7):329-335. doi: 10.1097/MBC.0000000000001456. PMID: 42615582. Heparin-induced thrombocytopenia (HIT) requires clinical evaluation and laboratory testing using immunological assays with confirmation by functional assays such […]

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Anticoagulant Therapy

Oct 9 2026

george

The ISTH Pulse Podcast Series: Anti-factor XIa Antithrombotics

Select ISTH: The Pulse Podcast to access a series of presentations that describe the emerging anti-FXIa antithrombotics. The site requests registration.

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Anticoagulant Therapy

Sep 30 2026

george

September 2026 QQ Summary: Anticoagulant Therapy for LAC Patients with VTE

Our September 2026 QQ asked: In your facility, what AC do you use for LAC patients with VTE? Our 13 respondents answered: Anti-Xa DOAC: 5 (39%) Warfarin: 8 (61%) No one chose an anti-IIa DOAC, aspirin, or “none.” There have been provocative discussions among KOL experts comparing the long-term use of warfarin (VKA) v. anti-Xa […]

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Thrombophilia

Sep 16 2026

george

Heparin Re-exposure in HIT Patients

Obtain this article about HIT from your local medical library: Caudill EB, Kim JH, Kanaan DM, Sylvester KW, Pimentel LY, Kim CS, Connors JM. Heparin re-exposure in patients with a history of heparin-induced thrombocytopenia. J Thromb Haemost. 2026 Aug 3:S1538-7836(26)00484-8. doi: 10.1016/j.jtha.2026.07.024. PMID: 42546848. Objective To evaluate heparin re-exposure practices and safety in patients with […]

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Anticoagulant Therapy

Sep 2 2026

george

PT/INR and PTT Therapeutic Levels

From Jessica Warner, Kettering Health: Hi George, I was wondering whether there has ever been a discussion about evaluating these ranges and whether there’s a consensus on what they should be. I have been in my job for 12 years and never looked at them to change them until an AC at another health system […]

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Anticoagulant Therapy

Aug 31 2026

george

September 2026 QQ: Anticoagulant Therapy for LAC Patients with VTE

Our September 2026 Quick Question is a poll that asks: In your facility, what AC is used for LAC patients with VTE? Anti-Xa DOAC  Anti-IIa DOAC  Warfarin  Aspirin  None AC therapy is indicated for VTE, including VTE and fetal loss associated with the presence of chronic LAC in the plasma. The commonly used anti-FXa DOACs […]

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Anticoagulant Therapy

Aug 24 2026

george

DOAC Pharmacodynamics and Potential Near-patient Decision Making

Access your ISTH membership or medical library for a ground-breaking JTH Forum article: Shaw JR, Ansell J. A light in the dark-reframing direct oral anticoagulant pharmacokinetics and pharmacodynamics for near-patient decision-making. J Thromb Haemost. 2026;24(8):2726-2731. doi: 10.1016/j.jtha.2026.05.016. Epub 2026 May 21. PMID: 42173287. Abstract Direct oral anticoagulant (DOAC) level testing is needed most when decisions […]

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Anticoagulant Therapy

Aug 17 2026

george

Simplified DOAC–Stop Proof of Concept

Click here for this 2024 open-access article describing the use of DOAC-Stop®: Exner T, Dangol M, Favaloro EJ. Simplified method for removing direct oral anticoagulant interference in mechanical coagulation test systems–a proof of concept. J Clin Med. 2024;13:1042. doi: 10.3390/jcm13041042. PMID: 38398355; PMCID: PMC10889288. Abstract Background: Direct oral anticoagulants (DOACs) cause unwanted interference in various […]

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Anticoagulant Therapy