Mar 1 2022

george

March 2022 Quick Question: Measuring Anti-Xa DOACs

Please review and answer our March 2022 Quick Question, submitted by colleague and coagulation expert Dave McGlasson. Although the US FDA has never approved the chromogenic anti-Xa assay for the direct oral anticoagulants rivaroxaban and apixaban, calibrators and controls are available from several distributors. Many facilities are called upon to assay for plasma concentration in […]

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Anticoagulant Therapy

Feb 18 2022

george

Measuring DOACs

Here is a helpful article from the January 17, 2022 issue of CAP Today: “Measuring Direct Oral Anticoagulants—When, How.”

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Anticoagulant Therapy

Feb 18 2022

george

PIVKA

George is updating a book chapter and asks if there is a reason to continue using the phrase “proteins induced by vitamin K absence/antagonists” [PIVKA], now termed des-gamma-carboxy- II, VII, IX, or X. Does any laboratory continue to offer a PIVKA assay?

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Anticoagulant Therapy

Jan 6 2022

george

The Fiix-PT Assay; Improves on PT-INR?

I [Geo] received a communication from Dr. Pall Onundarson, Hematology Laboratory and Thrombosis and Hemostasis Service, Faculty of Medicine, University of Iceland, Reykjavik, Iceland, about the Fiix-PT assay designed to monitor vitamin K antagonist [warfarin, Coumadin] therapy unaffected by reductions in FVII and FIX which the authors claim to play little role in clinical anticoagulation. […]

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Anticoagulant Therapy

Nov 30 2021

george

December 2021 Quick Question: Thrombosis Risk Profile

Our December 2021 question asks, “The resident orders a thrombosis risk profile on an inpatient being treated for a pulmonary embolism [PE]. How do you respond?” This question is inspired by a case study we developed for Rutgers’ CLSC 5124 Advanced Hemostasis fall, 2021 online graduate course. Above is a screen capture that lists several […]

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Anticoagulant Therapy

Jun 29 2021

george

June, 2021 Quick Question: Dabigatran Reversal Agent

Our June, 2021 Quick Question asks, “What is the trademark name of the dabigatran reversal agent?” Here are the answers from our 25 respondents. Andexxa: 0% Bevyxxa: 8% [2] Praxbind: 88% [22] KCentra: 0% Aripazine: 4% [1] No one was stumped by this one, perhaps as we had recently posted a question about Andexxa, which […]

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Anticoagulant Therapy

Jun 23 2021

george

FDA Approves Pradaxa for Children

Thanks to Dean Willett, Precision BioLogic Inc., for today’s heads-up for this FDA announcement [click] approving dabigatran etixalate [Pradaxa®] therapy for children 3 months–12 years who have experienced venous thromboembolic disease.

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Anticoagulant Therapy

May 31 2021

george

June, 2021 Quick Question: Dabigatran Reversal Agent

Our June Quick Question opens additional discussion of the DOAC reversal agents as it asks, “What is the trademark name of the dabigatran reversal agent? Please click your answer and provide your experience with reversal agents in the comments section below.

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Anticoagulant Therapy

May 28 2021

george

Question About DOAC Side Effects

To our FF participants, a colleague asked whether Eliquis was associated with confusion. Have you observed any side effects for any of the DOACs other than the well-described risk of gastrointestinal or intracranial hemorrhage? Thank you for your response.

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Anticoagulant Therapy

May 2 2021

george

April 2021 Quick Question: Andexanet Alfa Response

Thanks to our 31 participants for answering the April, 2021 Quick Question, “What test do you employ to validate the need for andexanet alfa to reverse DOAC overdose?” Here are our responses: PT: 3% [1] PTT: 17% [5] Chromogenic anti-Xa: 77% [24] DOAC Dipstick: 3% [1] This question arose from a conversation with the director […]

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Anticoagulant Therapy