March 2026 QQ: LAC Assay

Our March 2026 Quick Question was a poll that asked: “How do you test for LAC when the patient is on a DOAC?” Our 19 respondents answered:

1. Don’t test: 3 (15%)
2. Go ahead and test: 2 (11%)
3. Use a DOAC neutralizer: 12 (63%)
4. Test only for anticardiolipin antibody and anti-Β2GP1: 2 (11%)

The DOAC neutralizers DOAC-Stop or DOAC-Remove are effective at removing DOACs from plasma and do not interfere with LAC testing. They await approval in Canada and the USA and are designated RUO in most North American facilities, though a few tertiary care facilities choose to await approval. The enzyme immunoassay methods for ACA and anti-Β2GP1 are unaffected by DOACs and provide reliable clinical information.