Oct 20 2020

george

Warfarin and Cannabis

Thanks to hemostasis expert and colleague Dave McGlasson for a recent phone discussion on the effects of marijuana on warfarin therapy [disclaimer: no personal experience]. A literature search turned up several studies and meta-analyses associating THC with markedly raised INR, implying an effect on the cytochrome oxidase pathway. Click review article Damkier P, Lawwen D, […]

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Anticoagulant Therapy

Oct 15 2020

george

In vitro detection and removal of DOACs from patient plasma specimens

Announcing a 9-30-20 open access publication [forgive the self-reference]: McGlasson DL, Fritsma, GA. In vitro detection and removal of direct oral anticoagulants from patient plasma specimens. Annals of Blood 2020:doi: 10.21037/aob-20-16. We describe a urine DOAC Dipstick and several competing “filter” devices that remove DOACs from plasma, enabling the operator to perform clot-based [PT and […]

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Anticoagulant Therapy

Oct 3 2020

george

Apixaban Assay Approved

On 9-22-20, Instrumentation Laboratory, A Werfen Company, received US FDA de novo approval for their automated chromogenic HemosIL® Liquid Anti-Xa test kit to measure apixaban [Eliquis]. Click here for IL‘s press release.

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Anticoagulant Therapy

Sep 28 2020

george

In Vitro DOAC ID and Removal

We reported on the DOAC-Dipstick®, and four in vitro devices designed to remove interfering DOACs from specimens prepared for clot-based and chromogenic substrate assays in our 9-30-20 article [click], McGlasson DL, Fritsma GA. In vitro detection and removal of direct oral anticoagulants from patient plasma specimens. Annals of Blood 9-30-20; doi: 10.21037/aob-20-16. These devices are […]

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Anticoagulant Therapy

Sep 26 2020

george

Covid-Coag Conversation Video

Thanks to all who participated in our  September 15, 2020 webinar, “COVID-Associated Coagulopathy: A Conversation about the Controversies & Confusion” [click] featuring Dr. Andrew Goodwin, University of Vermont Medical Center. Click the title line if you would like to view the webinar again or if you did not have the opportunity to attend the live […]

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Anticoagulant Therapy

Sep 18 2020

george

Dilute Thrombin Time

From Deanna Miller, Children’s Hospital of Alabama. Do you have any good references for diluted thrombin and utilization of this test?  What dilution is best? 1:1 or 1:3? Hello, Deanna, and thank you for your question. We use the plasma-diluted thrombin time to measure the direct thrombin inhibitors [DTIs] dabigatran, argatroban, or bivalirudin. The assay […]

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Anticoagulant Therapy

Jul 21 2020

george

What is Osocimab?

The first phase 2 antithrombotic efficacy and safety results for the novel anti-activated coagulation factor XI [anti-XIa] monoclonal antibody are reported in Weitz JI, Bauersachs R, Becker B, et al. Effect of osocimab in preventing venous thromboembolism among patients undergoing knee arthroplasty; The FOXTROT randomized clinical trial JAMA. 2020;323:130–9. doi:10.1001/jama.2019.20687. This is an exciting new approach […]

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Anticoagulant Therapy

Jul 17 2020

george

Can Heparin Prevent Covid?

Thanks to George’s colleague Rodney Rohde, PhD, Texas State University, who posted this Contagion Live article by Grant M. Gallagher on LinkedIn entitled FDA-Approved Anticoagulant May Stop Coronavirus From Binding to Human Cells [click or tap]. This is a suprising and apparently authentic description of a non-antithrombotic Covid-preventative property of heparin, separate from heparin’s prophylactic […]

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Anticoagulant Therapy

Jul 7 2020

george

Covid and Hemostasis Riley Article

For a succinct summary of hemostasis mechanisms and management in the Covid-19 infection, see Riley P. Pandemic care: The need for hemostasis testing in critically ill COVID-19 patients. MLO 5-20-20, accessed 7-7-20. Also visit Stago’s Edvantage Virtual University for their recent program, Thromboembolism in COVID-19: Laboratory Considerations by Michael P Gulseth, Pharm. D., BCPS, FMSHP, […]

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Anticoagulant Therapy

Jul 1 2020

george

INR and HCT Case

I [Geo] received this question from a participant on June 29, 2020: If I am at 3 for my CoaguChek reading can my hematocrit be 45 or more?  Does INR affect hematocrit? I have secondary polycythemia, had an unprovoked DVT and PE and take warfarin. I tet therapeutic phlebotomies, but just question if I’m at […]

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Anticoagulant Therapy