Anticoagulants directs oraux: Actualités pour les biologistes

Translated title of the contribution: Non-VKA oral anticoagulants: An update for the clinical biologists

François Mullier, Jonathan Douxfils, Anne Tamigniau, Jean Michel Dogné, Marie Hélène Horellou, Claire Flaujac, Bernard Chatelain, Catherine Goffinet, Meyer Michel Samama, Isabelle Gouin-Thibault

Research output: Contribution to journalReview articlepeer-review

Abstract

Non-VKA oral anticoagulants (NOACs), thanks to their ease of use and their similar or superior safety/efficacy profiles versus warfarin, have now widely reached the lucrative market of anticoagulation. However, while the marketing authorization holders always claim, in a quite unclear way that no monitoring is required, accumulative evidence and cases of major bleeding have been described in the literature and reported by spontaneous reporting systems at the regulator's level. These compounds are usually given at fixed doses without routine coagulation monitoring. However, new data suggests that an assessment of the response at the individual level could improve the benefit-risk ratio of, at least dabigatran. Therefore, in certain patient populations, i.e. acute or chronic renal impairment or multiple drug interactions, measurement of drug exposure may be useful to ensure an optimal treatment response. More specific circumstances such as patients experiencing a haemorrhagic or thromboembolic event during the treatment duration, patients who require urgent surgery or an invasive procedure, or patient with a suspected overdose could benefit from such a measurement. This article aims at providing guidance on how to best estimate the intensity of anticoagulation using laboratory assays in daily practice.

Translated title of the contributionNon-VKA oral anticoagulants: An update for the clinical biologists
Original languageFrench
Pages (from-to)333-344
Number of pages12
JournalAnnales de biologie clinique
Volume73
Issue number3
DOIs
Publication statusPublished - 1 May 2015

Keywords

  • Anticoagulant
  • Apixaban
  • Coagulation
  • Dabigatran
  • Monitoring
  • NOAC
  • Rivaroxaban

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