Anticoagulant Therapy

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 […]

Anticoagulant Therapy

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.

Anticoagulant Therapy

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.

Anticoagulant Therapy

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.

Anticoagulant Therapy

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 […]

Anticoagulant Therapy

April 2021 Quick Question: Andexanet Alfa

Our April Quick Question arises from discussions with Chad Siniard, MD., University of Alabama at Birmingham Division of Laboratory Medicine and hemostasis author and expert Dave McGlasson. Andexanet Alfa® is the FDA-approved reversal agent for rivaroxaban and apixaban that has become a standard ER treatment for potential anticoagulant overdose. A key consideration is the US […]

Anticoagulant Therapy

D-dimer and DOACs

Here is a recent question from a colleague. “Dear George, A patient with a PE of unknown etiology, is now completing their 6th month of Eliquis therapy. When is the ideal time to check a D-dimer? Thank you.” Before answering, I [Geo] consulted with Dr. Larry Brace, who responds, “My opinion is that if the […]

Anticoagulant Therapy

Jan, 2021 QQ: CFX Answers

Our January, 2021 Quick Question asked, “How does your facility monitor warfarin in an atrial fibrillation [AFIB] patient with lupus anticoagulant [LAC]? The answers were… PT–INR; it is valid in LAC [33%] Chromogenic factor X [10, CFX] [33%] Chromogenic anti-factor Xa [23%] None: we switch to a DOAC [11%] Our question attracted too small a […]

Anticoagulant Therapy

Jan, 2021 QQ: The Chromogenic Factor X Assay

Before 2010, several articles were published supporting the chromogenic factor X [CFX] assay [not to be confused with the chromogenic anti-factor Xa heparin assay] for monitoring warfarin therapy, especially in patients whose lupus anticoagulant [LAC} could falsely prolong the prothrombin time. Two of these articles are attached below. While the data published made it clear […]

Anticoagulant Therapy

DOAC-STOP In Vitro DOAC Removal and LAC

From Asha Rajai: Is it OK to use DOAC-STOP for lupus testing? Has it been approved by ISTH or CLSI? Hello, Asha. Yes, DOAC-STOP [DiaPharma] and DOAC-Remove [Aniara] effectively absorb dabigatran, rivaroxaban, or apixaban from specimens that are submitted for lupus anticoagulant [LAC] testing, allowing for accurate PTT– and DRVVT-based screen and confirm assays for […]

Anticoagulant Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

Cheat Sheets from George

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