The Myths Behind DOAC Measurement: Analyses of Prescribing Information from Different Regulatory Bodies and a Call for Harmonization

Robert C Gosselin, Emmanuel J Favaloro, Jonathan Douxfils

Résultats de recherche: Contribution à un journal/une revueArticleRevue par des pairs

55 Téléchargements (Pure)

Résumé

For more than a decade, US laboratories have failed to implement solutions to help their clinicians in managing complex situations or patients on direct oral anticoagulants (DOACs). The problem may find different origins, among which is the position of the Food and Drug Administration, which categorized these drugs as monitoring- and measurement-free, whereas other regulatory bodies like the European Medicines Agency or the Therapeutic Goods Administration in Australia were more conservative on the principle that the absence of proof (of monitoring/measurement benefits) is not proof of an absence (of monitoring/measurement needs). Pivotal clinical studies that led to the approval of DOACs were presented as devoid of such testing, although some companies considered monitoring as a solution to improve their benefit/risk ratio. In this JTH In Clinics issue, we report more than a decade of development that has permitted the activation of smart laboratory solutions to qualify or quantify DOACs and discuss myths and misconceptions around technical and regulatory requirements that support the current reluctance of implementing these technologies in most US laboratories. Use of DOACs is ever expanding, with DOAC prescriptions now exceeding those of other anticoagulants, including vitamin K antagonists, in some geographies. As this use increases, the likely need to measure DOAC exposure will also increase. Measurement of DOACs does not represent any technical difficulty. That these laboratory tests are not available in some locations suggests disparities in patient care, and we suggest it is time to address such inequalities.

langue originaleAnglais
Pages (de - à)2494-2506
Nombre de pages13
journalJournal of Thrombosis and Haemostasis
Volume20
Numéro de publication11
Date de mise en ligne précoce16 sept. 2022
Les DOIs
Etat de la publicationPublié - nov. 2022

Empreinte digitale

Examiner les sujets de recherche de « The Myths Behind DOAC Measurement: Analyses of Prescribing Information from Different Regulatory Bodies and a Call for Harmonization ». Ensemble, ils forment une empreinte digitale unique.

Contient cette citation