Résumé
Possibilities to monitor rivaroxaban therapy could be useful in certain circumstances. Prothrombin time (PT) or chromogenic anti-Xa assays such as the Biophen Direct Factor Xa Inhibitor® (DiXaI) have been proposed to estimate rivaroxaban concentrations but are mainly based on in vitro studies. The study aim was to compare PT and Biophen DiXaI® measurements with liquid chromatography-tandem mass spectrometry (LC-MS/MS) measurements in plasma samples from patients treated with Xarelto®. Fifty-two plasma samples were included. PT was performed using Innovin® and Triniclot PT Excel S®. Biophen DiXaI® was performed according to instructions from the manufacturer. The rivaroxaban plasma concentration ranged between 0 and 485 ng/ml as measured by LC-MS/MS. The limits of quantification were 30 ng/ml and 5 ng/ml for Biophen DiXaI® and LC-MS/MS, respectively. The linear correlation between Biophen DiXaI® and LC-MS/ MS analyses was high for all rivaroxaban concentrations (r2 = 0.95). For concentrations _100 ng/ml, r2-value was 0.83. The Bland-Altman analysis showed a mean difference of -16 ng/ml (SD: 25 ng/ml). The PT methods did not correlate well with plasma concentrations measured by LC-MS/MS (r2 _ 0.60). In conclusion, the important interindividual variability and the poor correlation with LC-MS/MS preclude the use of PT to estimate rivaroxaban concentrations. Thanks to its small inter-individual variability and good agreement with LC-MS/ MS measurements, we recommend the use of Biophen DiXaI® assays to estimate concentrations of rivaroxaban >30 ng/ml. Quantification of low rivaroxaban levels (
langue originale | Anglais |
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Pages (de - à) | 723-731 |
Nombre de pages | 9 |
journal | Thrombosis and Haemostasis |
Volume | 110 |
Numéro de publication | 4 |
Les DOIs | |
Etat de la publication | Publié - 11 juil. 2013 |
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Evaluation of thrombotic and/or bleeding risks associated with anticoagulotherapy.
Douxfils, J. (Auteur)Dogne, J.-M. (Promoteur), Mullier, F. (Promoteur), Masereel, B. (Président), Chatelain, B. (Jury), Chatelain, C. (Jury), Verhamme, P. (Jury), TEN CATE, H. (Jury) & Ageno, W. (Jury), 24 oct. 2015Student thesis: Doc types › Docteur en Sciences Biomédicales et Pharmaceutiques