The addition of idarucizumab to plasma samples containing dabigatran allows the use of routine coagulation assays for the diagnosis of hemostasis disorders

Journal of Thrombosis and Haemostasis : JTH
M JacqueminP Verhamme

Abstract

The anticoagulant effect of dabigatran can be approximated by its prolongation of routine coagulation assays. Consequently, dabigatran also interferes with thrombophilia screening or with diagnosing hemostasis disorders that have developed after the initiation of anticoagulant treatment, such as vitamin K deficiency or acquired hemophilia A. This study was carried out to determine whether idarucizumab, a humanized antibody fragment that binds dabigatran, could fully neutralize dabigatran in routine diagnostic coagulation assays conducted in vitro, thereby preventing false-positive or false-negative diagnostic readouts. Preliminary experiments identified coagulation assays that were sensitive to dabigatran, and identified a concentration of idarucizumab that neutralized the effects of dabigatran. These assays were then carried out with patient and control plasma samples spiked with dabigatran, with or without a molar excess of idarucizumab. Dabigatran altered the prothrombin time, activated partial thromboplastin time and thrombin time, and the measurement of intrinsic and extrinsic factor levels. Screening and confirmation tests used for lupus anticoagulant detection were prolonged by dabigatran, falsely suggesting the presence...Continue Reading

References

Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Dec 8, 2009·The New England Journal of Medicine·Sam SchulmanUNKNOWN RE-COVER Study Group
Jan 1, 2010·The New England Journal of Medicine·Donald Stuart Houston, Ryan Zarychanski
Nov 26, 2010·Thrombosis and Haemostasis·Tomas L LindahlUNKNOWN Expert Group on Coagulation of the External Quality Assurance in Laboratory Medicine in Sweden
Jul 27, 2011·Archives of Internal Medicine·Matthieu LegrandDidier Payen
Dec 29, 2012·American Journal of Clinical Pathology·Dorothy M AdcockDenis M Dwyre
Feb 22, 2013·The New England Journal of Medicine·Sam SchulmanUNKNOWN RE-SONATE Trial Investigators
Mar 12, 2013·Blood·Felix SchieleTobias Litzenburger
Jun 21, 2013·European Journal of Clinical Pharmacology·Jovan P AntovicRickard E Malmström
Mar 19, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Linda StangArtur J Szkotak
Sep 19, 2014·Thrombosis and Haemostasis·M Van BlerkP Van de Walle
Jun 23, 2015·The New England Journal of Medicine·Charles V PollackJeffrey I Weitz

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Citations

Apr 15, 2016·Thrombosis and Haemostasis·Franz RatzingerPeter Quehenberger
May 12, 2016·Expert Review of Hematology·Thomas VanasschePeter Verhamme
Jul 14, 2016·Haemophilia : the Official Journal of the World Federation of Hemophilia·D M AdcockS A de Lima Montalvão
Jul 9, 2016·The Annals of Pharmacotherapy·Dinesh YogaratnamJeffrey J Fong
May 19, 2019·Journal of Thrombosis and Haemostasis : JTH·Glynis FransEls Bailleul
Sep 6, 2019·International Journal of Laboratory Hematology·Juliette GayGeorges Jourdi
May 14, 2020·Journal of Thrombosis and Haemostasis : JTH·Pieter M De Kesel, Katrien M J Devreese
Dec 2, 2016·Antibodies·Gary W Moore
Aug 6, 2019·American Journal of Hematology·Emmanuel J Favaloro
Jun 21, 2020·Current Rheumatology Reports·Katrien M J Devreese
Jun 17, 2020·International Journal of Laboratory Hematology·Katrien M J Devreese
Mar 17, 2021·Scientific Reports·Mojca Božič MijovskiAlenka Mavri

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