Sathanantham, Vepusha; Alberio, Lorenzo; Bovet, Cédric; Fontana, Pierre; Gerber, Bernhard; Graf, Lukas; Mendez, Adriana; Sauter, Thomas C; Schmidt, Adrian; Studt, Jan-Dirk; Wuillemin, Walter A; Nagler, Michael (2022). Prothrombinase-Induced Clotting Time to Measure Drug Concentrations of Rivaroxaban, Apixaban, and Edoxaban in Clinical Practice: A Cross-Sectional Study. Life, 12(7) MDPI 10.3390/life12071027
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Prothrombinase-induced clotting time (PiCT) is proposed as a rapid and inexpensive laboratory test to measure direct oral anticoagulant (DOAC) drug levels. In a prospective, multicenter cross-sectional study, including 851 patients, we aimed to study the accuracy of PiCT in determining rivaroxaban, apixaban, and edoxaban drug concentrations and assessed whether clinically relevant drug levels could be predicted correctly. Citrated plasma samples were collected, and the Pefakit® PiCT was utilized. Ultra-high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to measure drug concentrations. Cut-off levels were established using receiver-operating characteristics curves. We calculated sensitivities and specificities with respect to clinically relevant drug concentrations. Spearman's correlation coefficient between PiCT and drug concentrations was 0.85 in the case of rivaroxaban (95% CI 0.82, 0.88), 0.66 for apixaban (95% CI 0.60, 0.71), and 0.78 for edoxaban (95% CI 0.65, 0.86). The sensitivity to detect clinically relevant drug concentrations was 85.1% in the case of 30 µg L-1 (95% CI 82.0, 87.7; specificity 77.9; 72.1, 82.7), 85.7% in the case of 50 µg L-1 (82.4, 88.4; specificity 77.3; 72.5, 81.5), and 85.1% in the case of 100 µg L-1 (80.9, 88.4; specificity 73.2%; 69.1, 76.9). In conclusion, the association of PiCT with DOAC concentrations was fair, and the majority of clinically relevant drug concentrations were correctly predicted.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center |
UniBE Contributor: |
Bovet, Cédric, Sauter, Thomas Christian, Nagler, Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2075-1729 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
29 Jul 2022 09:52 |
Last Modified: |
05 Dec 2022 16:22 |
Publisher DOI: |
10.3390/life12071027 |
PubMed ID: |
35888115 |
Uncontrolled Keywords: |
apixaban cross-sectional studies diagnostic accuracy direct oral anticoagulants edoxaban laboratory monitoring prothrombinase-induced clotting time rivaroxaban sensitivity and specificity |
BORIS DOI: |
10.48350/171598 |
URI: |
https://boris.unibe.ch/id/eprint/171598 |
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