What recommendations are available for laboratory monitoring of direct oral anticoagulants (DOAC)?

Comment by InpharmD Researcher

Direct oral anticoagulants can prolong clotting tests such as prothrombin time (PT), INR, and activated partial thromboplastin time (aPTT). Anti-Xa (calibrated) may be a valuable quantitative test; however, reagent sensitivities and variabilities in laboratory calibrations impact assay results. As such, routine monitoring of DOAC concentrations is not recommended by guidelines at this time. The only current accurate monitoring tests for DOACs are drug trough levels.
Background

According to a guidance document by the Anticoagulation Forum, an optimal method for heparin monitoring is currently unknown and the current national guidelines do not prefer one method over another for heparin monitoring. Anti-Xa levels are less impacted by biological variables such as clotting factors when compared to activated partial thromboplastin time (aPTT). Both aPTT and anti-Xa results are affected by several pre-analytic and analytic variables; however, anti-Xa monitoring is more costly than aPTT and less accessible to clinicians. Benefits of anti-Xa include fewer monitoring tests, fewer dose changes, and a shorter time to reach therapeutic levels. Furthermore, anti-Xa may be useful in patients with heparin resistance, a prolonged baseline aPTT, or altered heparin response. Both aPTT and anti-Xa levels should be checked every six hours until two consecutive therapeutic levels are established. Monitoring can then be altered to once daily. [1]

The use of anti-Xa assays to monitor unfractionated heparin (UFH) levels in patients who have transitioned from direct oral anticoagulants (DOACs) may yield unquantifiable or inaccurate results that can lead to inappropriate UFH doses and treatment failures. Manufacturer labeling of oral factor Xa inhibitors does not provide specific guidance regarding this issue. Anti-Xa levels are strongly affected by oral factor Xa inhibitors, but aPTT is minorly or not affected (depending on the agent). [2]

Due to the lack of adequate guidance, a 2016 review recommends considering aPTT assay monitoring over anti-Xa monitoring in patients taking DOACs. In addition, it recommends the following strategies when converting from an oral anti-Xa inhibitor to UFH: 1) verify the time of the last anti-Xa dose; 2) initiate UFH infusion without bolus approximately two hours prior to when the next scheduled anti-Xa would have been given; 3) monitor UFH with aPTT every six to eight hours for the first 48 hours (or 72 hours for those with hepatic or renal impairments); and 4) switch to anti-Xa assay monitoring, if desired; however, consider switching back to aPTT if anti-Xa levels are above 1.10 IU/mL for two consecutive readings. [2]

Overall, there are insufficient data supporting routine monitoring of DOAC levels to predict either thrombotic or bleeding risk in a given patient. Limited data from studies that tried to use laboratory assessments only performed measurements once or twice, and they were often remote from the clinical event to correlate with drug levels. Because of short half-lives of DOACs, it is difficult to rely on traditional laboratory values (i.e., PT, aPTT, thrombin time, anti-Xa), because skipping even 1 dose alters the levels greatly. Thrombin time is very sensitive to dabigatran, and when normal; it suggests a clinically insignificant amount of dabigatran in plasma. Specific DOAC-calibrated non-FDA approved assays are available; however, not many hospitals can provide rapid results (<30 minutes). Routinely used, some heparin assays may provide sufficient information on FXa activity to make some clinical decisions. [3], [4], [5], [6]

Since there are no FDA-approved methods to monitor the anticoagulant effect of DOACs, anti-factor Xa tests can quantitatively assess anticoagulation effects. However, it should be noted that standardized therapeutic ranges have not been established for DOACs and quantitative test results have not been correlated with clinical outcomes. Qualitative coagulation assays such as activated partial thromboplastin time, thrombin time, and prothrombin time can be used as first‐line tests if an evaluation for medication compliance is clinically important; however, these tests are insufficient to assess the degree of anticoagulant effect as seen with INR for warfarin management. Currently, the only accurate monitoring for DOACs are drug trough levels, which can be used to exclude drug accumulation or when drug failure is suspected. [4], [5], [6]

A 2019 retrospective study (presented as a poster abstract) studied the anti-Xa assay "interference" when switching from a DOAC to heparin infusions in patients with renal dysfunction, on concomitant interacting medications, and with BMI > 40 kg/m^2. Patients were excluded if no interference was not met, or if the initial level did not show interference. Most of the 68 patients were on apixaban (85%) and the rest were on rivaroxaban (15%) before transitioning to heparin. The mean duration of interference was 69.3 ± 46.2 hours, and the median (interquartile range) duration was 62.7 (48–84) hours. No significant difference in duration of interference existed between patients with normal renal function compared to those with dynamic renal function (P=0.84) or with BMI > 40 kg/m^2 (P=0.16); however, patients taking interacting medications (unspecified) experienced a longer time to correct anti-Xa assays (P=0.012). [7]

Another study measured the testing interferences between DOACs and heparins in 10 healthy blood donors and 9 patients who were on a DOAC. There was no influence of dabigatran could be demonstrated in the anti-Xa testing methods for LMWH, UFH, rivaroxaban, or apixaban. All factor Xa-inhibiting drugs affected all the anti-Xa testing methods in their own specific ways. Since this data used in vitro blood samples and drug spiking for measurements, clinical considerations could not be drawn. Nonetheless, the authors suggest heparin therapy should be started only after measuring the residual concentration of the used DOAC with an appropriate assay and not before a concentration lower than 30 ng/mL has been achieved. [8]

References:

[1] Smythe MA, Priziola J, Dobesh PP, Wirth D, Cuker A, Wittkowsky AK. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):165-86.
[2] Faust AC, Kanyer D, Wittkowsky AK. Managing transitions from oral factor Xa inhibitors to unfractionated heparin infusions. Am J Health Syst Pharm. 2016;73(24):2037-2041.
[3] Sarode R. Direct oral anticoagulant monitoring: what laboratory tests are available to guide us?. Hematology Am Soc Hematol Educ Program. 2019;2019(1):194-197. doi:10.1182/hematology.2019000027
[4] Chen Ashley, Stecker Eric, A. Warden Bruce. Direct oral anticoagulant use: a practical guide to common clinical challenges. Journal of the American Heart Association. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559
[5] Douxfils J, Ageno W, Samama CM, et al. Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. J Thromb Haemost. 2018;16(2):209-219. doi:10.1111/jth.13912
[6] Moner-Banet T, Alberio L, Bart PA. Does one dose really fit all? On the monitoring of direct oral anticoagulants: A review of the literature. Hamostaseologie. 2020;40(2):184-200. doi: 10.1055/a-1113-0655
[7] Plum M, Hedrick J, Hockman R, et al. 879: Duration Of Anti-Xa Assay Interference When Transitioning From Direct Oral Anticoagulants To Heparin. Crit Care Med. 2019;47(1):418.
[8] Eller T, Flieder T, Fox V, et al. Direct oral anticoagulants and heparins: laboratory values and pitfalls in 'bridging therapy'. Eur J Cardiothorac Surg. 2017;51(4):624-632.

Literature Review

A search of the published medical literature revealed 3 studies investigating the researchable question:

What recommendations are available for laboratory monitoring of direct oral anticoagulants (DOAC)?

Please see Tables 1-3 for your response.


 

Interference of Direct Oral Anticoagulants (DOACs) with Various Coagulation Assays

Test

Dabigatran

Rivaroxaban Apixaban Edoxaban Notes
PT ↓↓/↓↓↓ ↓/↓↓ ↓↓
All factors affected
 
Most sensitive to rivaroxaban
 
Depends on the reagent
aPTT ↓↓↓ ↓↓ ↓/↓↓ ↓/↓↓
All factors affected
 
Most sensitive to dabigatran
 
Depends on the reagent
 
Rivaroxaban also interferes with one-stage and chromogenic factor VIII:C assays
 
Clotting assays based on activation of coagulation at
prothrombinase level unaffected by FXa inhibitors
Antithrombin activity none to ↑ none to ↑ none to ↑ none to ↑
Anti-thrombin-based assays affected by dabigatran
 
Anti-FXa-based assays affected by the FXa inhibitors

 

References:

Chen Ashley, Stecker Eric, A. Warden Bruce. Direct oral anticoagulant use: a practical guide to common clinical challenges. Journal of the American Heart Association. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559

Douxfils J, Ageno W, Samama CM, et al. Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. J Thromb Haemost. 2018;16(2):209-219. doi:10.1111/jth.13912

 

Characteristics of Coagulation Tests for Estimating Plasma Concentrations of Direct Oral Anticoagulants

Drug Laboratory Test

Utility/Interpretation

Reagent Dependent?
Dabigatran

Activated partial thromboplastin (aPTT)

Normal APTT excludes above on‐therapy dabigatran levels but does not exclude the presence of dabigatran in the on‐therapy range

Yes

Thrombin time (TT)

Normal TT excludes the presence of dabigatran. A prolonged TT could suggest either the presence of clinically relevant or trivial levels of dabigatran.

Yes

Dilute thrombin time (dTT)

Based on plasma concentration estimation in relation to the clinical context. Some methodologies (i.e. the Hemoclot Thrombin Inhibitors [HTI]) require specific calibrators for plasma concentrations <50 ng/mL

No

Ecarin clotting time (ECA)

Based on plasma concentration estimation in relation to the clinical context

No
Apixaban Prothrombin time (PT) Not sensitive enough to be used. May be prolonged at peak concentration. Yes

Chromogenic anti-Xa assays

Based on plasma concentration estimation in relation to the clinical context. Some methodologies (i.e. the Biophen Direct Factor Xa Inhibitors [DiXaI]) require specific calibrators for plasma concentrations <30–50 ng/mL.

No

Diluted Russell’s viper venom time (dRVV-T)

Normal dRVV result can exclude DOAC concentrations >50 ng/mL.

Yes
Rivaroxaban

Prothrombin time (PT)

Normal PT (with sensitive reagents) excludes above on-therapy rivaroxaban levels but does not exclude the presence of rivaroxaban in the on-therapy range.
Yes

Chromogenic anti-Xa assays

Based on plasma concentration estimation in relation to the clinical context. Some methodologies (i.e. the Biophen Direct Factor Xa Inhibitors [DiXaI]) require specific calibrators for plasma concentrations <30–50 ng/mL.

No

Diluted Russell’s viper venom time (dRVV-T)

Normal dRVV result can exclude DOAC concentrations >50 ng/mL.

Yes
Edoxaban

Prothrombin time (PT)

Normal PT (with sensitive reagents) would exclude
above on-therapy edoxaban levels at peak but would not exclude the presence of above on-therapy edoxaban at the trough.
Yes

Chromogenic anti-Xa assays

Based on plasma concentration estimation in relation to the clinical context. Some methodologies (i.e. the Biophen Direct Factor Xa Inhibitors [DiXaI]) require specific calibrators for plasma concentrations <30–50 ng/mL.

No

Diluted Russell’s viper venom time (dRVV-T)

Normal dRVV result can exclude DOAC concentrations >50 ng/mL.

Yes

 

References:

Chen Ashley, Stecker Eric, A. Warden Bruce. Direct oral anticoagulant use: a practical guide to common clinical challenges. Journal of the American Heart Association. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559

Moner-Banet T, Alberio L, Bart PA. Does one dose really fit all? On the monitoring of direct oral anticoagulants: A review of the literature. Hamostaseologie. 2020;40(2):184-200. doi: 10.1055/a-1113-0655

Douxfils J, Ageno W, Samama CM, et al. Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. J Thromb Haemost. 2018;16(2):209-219. doi:10.1111/jth.13912

 

Influence of Direct Oral Anticoagulants on Anti–Factor Xa Measurements Utilized for Monitoring Heparin

Design

Multicenter, retrospective chart review

N=50

Objective

To quantify the extent and duration of anti-factor Xa (anti-Xa) effect attributable solely to recent direct oral anticoagulant (DOAC) administration and to determine the influence of DOAC administration within the prior 72 hours on the initial anti-Xa levels drawn on an unfractionated heparin (UFH) infusion for those who transition to UFH and evaluate the number of anti-Xa lab draws necessary before reaching therapeutic range

Study Groups

Apixaban (n=20)

Rivaroxaban (n=30)

Methods

Inclusion criteria: patients who received apixaban, rivaroxaban, or edoxaban within 72 hours of anti-Xa collection

Exclusion criteria: none specified

This was a retrospective chart review of three affiliated community hospitals. Patients who had their anti-Xa levels drawn after a DOAC were compared to a historical cohort of patients who started heparin with no documentation of previous DOAC use.

Duration

October 2015 to June 2016

Outcome Measures

Influence of DOAC therapy on initial anti-Xa levels

Baseline Characteristics

  Apixaban (n=20) Rivaroxaban (n=30)
Age, years 75 66
Male 45% 57%

Inappropriate dose

Too low

Too High

35%

100%

0%

13%

25%

75%

Results

 

After recent DOAC (n=50) No DOAC (n=111)

Anti-Xa levels

Subtherapeutic (anti-Xa <0.3)

Therapeutic (anti-Xa 0.3-0.7)

Supratherapeutic (anti-Xa >0.7)

 

7%

24%

69%

 

28%

51%

21%

  Apixaban (n=20) Rivaroxaban (n=30)
Time until first anti-Xa level ≤7, hours (range) 52 (18-117) 39 (19-62)

Adverse Events

N/A

Study Author Conclusions

Rivaroxaban and apixaban can increase heparin-calibrated anti-Xa levels. Anti-anti-Xa may be used to monitor residual rivaroxaban and apixaban effects. When heparin is monitored by anti-Xa levels, it may be necessary to delay UFH initiation or consider alternative monitoring or alternative anticoagulants due to the effects of factor Xa on anti-Xa levels. 

 

References:

Macedo KA, Tatarian P, Eugenio KR. Influence of Direct Oral Anticoagulants on Anti-Factor Xa Measurements Utilized for Monitoring Heparin. Ann Pharmacother. 2018;52(2):154-159.