Coagulation assays responsive to dabigatran, rivaroxaban, apixaban and edoxaban
| Assay | Responsive within therapeutic range? | Included in US drug prescribing information?* |
|---|---|---|
| Dabigatran22–24 26 28 45–47 | ||
| aPTT | Provides estimate of effect | Yes |
| ECT | Quantifiable dose–response | Yes |
| TT | Too sensitive to give quantifiable results | No |
| Diluted TT | Quantifiable dose–response | Not in the USA |
| Rivaroxaban29–31 48–52 | ||
| PT (rivaroxaban-calibrated) | Quantifiable dose–response if PT performed with neoplastin | Yes |
| aPTT | Dose-dependent, but variable and less sensitive than PT | No |
| FXa (clot-based, eg, HepTest) | Quantifiable dose–response | No |
| FXa (chromogenic) | Quantifiable dose–response | No |
| Apixaban42 43 53 54 | ||
| PT/INR | Small and variable response | No |
| aPTT | Small and variable response | No |
| FXa (chromogenic) | Quantifiable dose–response | No |
| Edoxaban80 | ||
| PT | Large variability between reagents | No |
| aPTT | Less variability between reagents | No |
| Thrombin generation | Three times more sensitive to edoxaban | No |
Assays that can give quantifiable responses will typically require drug-specific and laboratory-specific calibration.
*Routine use of coagulation assays is not required with the novel oral anticoagulants.
aPTT, activated partial thromboplastin time; ECT, ecarin clotting time; FXa, factor Xa; INR, international normalised ratio; PT, prothrombin time; TT, thrombin time.