Novel Ex Vivo DOAC Removal Methods Reduce Interference in Lupus Anticoagulant Testing.
Diagnostics (Basel)
; 12(10)2022 Oct 17.
Article
en En
| MEDLINE
| ID: mdl-36292209
ABSTRACT
Direct oral anticoagulants (DOAC) interfere in laboratory coagulation testing. The aim here was to study how commercial DOAC removal methods, DOAC Filter® and DOAC-Stop™, perform to eliminate DOAC concentrations and false positive results in lupus anticoagulant (LAC) testing. We acquired 50 patient samples with high concentrations of DOACs apixaban (n = 18, range 68-572 ng/mL), dabigatran (n = 8, range 47-154 ng/mL), edoxaban (n = 8, range 35-580 ng/mL) and rivaroxaban (n = 16, range 69-285 ng/mL). DOACs were removed ex vivo with either DOAC Filter® (n = 28) or DOAC-Stop™ (n = 22). Additionally, commercial control and calibrator samples were studied (n = 13 for DOAC Filter®, n = 14 for DOAC-Stop™). LAC screening was performed before and after DOAC removal. Both DOAC Filter® and DOAC-Stop™ were effective in removing DOAC concentrations in samples DOAC concentrations decreased to median of 0 ng/mL (range 0-48 ng/mL). Only one sample had more than residual 25 ng/mL of DOAC (apixaban). Before DOAC removal, 96% (48/50) of patient samples and over 90% (12/13 DOAC Filter®, 13/14 DOAC-Stop™) of control/calibrator samples were positive in the LAC screening. In patient samples, LAC screening turned negative in 61% (17/28) after DOAC Filter® and 45% (10/22) after DOAC-Stop™ treatment. All control samples became negative after DOAC removal. In conclusion, DOAC removal ex vivo reduces false positives in LAC screening. DOAC removal halved the need for confirmation or mixing tests- Although a subset of patients would require further testing, DOAC removal reduces unnecessary repeated LAC testing.
Texto completo:
1
Bases de datos:
MEDLINE
Idioma:
En
Revista:
Diagnostics (Basel)
Año:
2022
Tipo del documento:
Article
País de afiliación:
Finlandia