From Kim Kinney at IU Health (formerly Clarian): Our coag lab is being asked by our heme/onc docs to have an assay for both Rivaroxaban and Dabigatran. I thought maybe you could poll your readers to see who is doing what type of assay if any! As always, thanks for your help.
Hi, Kim, it is good to hear from you, and I’m posting your question as a Quick Question so we can get a larger sample. Meanwhile, in the April, 2013 issue of J Thromb Haemostas there are counterpoint editorials by Dr. Armando Tripodi and Dr. Meyer Samamaabout measuring the anti-Xa antithrombotics rivaroxaban, apixaban, and edoxaban (not cleared). Dr Tripodi advocates for the prothrombin time, Dr. Samama for the anti-Xa. Dr. Samama specifically mentions Stago’s direct anti-Xa, which is not affected by antithrombin or any of the heparins.
For dabigatran, it looks like Stago’s ecarin chromogenic assay or Biophen’s plasma-diluted thrombin time are emerging as the two best approaches. The standard thrombin time can be used as a “quick and dirty” qualitative assay.
By the way, all of the assays mentioned are currently for research use only until the FDA clears them.
Below, I’ve attached an excellent article published last month that reviews all the new oral anticoagulants, dosages, lab measurement, and limitations. I hope this helps!