Naslov
Direct oral anticoagulants (DOACs): from the laboratory point of view

Autori
Margetić, Sandra ; Šupraha-Goreta, Sandra ; Ćelap, Ivana ; Razum, Marija

Izvornik
Acta pharmaceutica (1330-0075) 72 (2022), 4; 459-482

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, znanstveni

Ključne riječi
direct oral anticoagulants (DOACs), anticoagulation, laboratory monitoring

Sažetak
Direct oral anticoagulants (DOACs) represent a new genera- tion of drugs that have been increasingly used in the preven- tion and treatment of thromboembolic states. According to the mechanism of anticoagulant action, DOACs are divided into two groups: direct inhibitors of thrombin (dabigatran) and direct inhibitors of activated factor X (FXa) (rivaroxaban, apixaban, edoxaban, betrixaban). Compared to the vitamin K antagonists, DOACs are superior in terms of onset of action, pharmacokinetic and pharmacodynamics properties and fixed daily dose without the need for routine coagulation monitoring. Despite these advantages, there are clinical con- ditions in which laboratory measurement of DOACs should be performed. Although DOACs have an impact on screen- ing haemostasis assays (prothrombin time, PT ; activated par- tial thromboplastin time, aPTT ; and thrombin time, TT), these tests are not appropriate for quantifying drug levels. Therefore, specific quantitative methods (LC-MS/MS as a gold standard method for all DOACs, coagulometric and chromogenic assays for dabigatran, and chromogenic anti-Xa assays with drug-specific calibrators for inhibitors of FXa) should only be used for determination of DOACs concentra- tion. The aim of this review is to present all aspects of labora- tory assessment of DOACs, including pre-analytical, analyti- cal and post-analytical factors in the overall testing process with a special accent on the available specific quantitative methods for measurement of DOACs in circulation.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

POVEZANOST RADA