@article{
author = "Kovač, Mirjana and Basarić, Dušica and Tomić, Branko and Gvozdenov, Maja and Backović, Dragana and Lalić-Ćosić, Sanja",
year = "2022",
abstract = "Background/Aim. Direct oral anticoagulants (DOACs) administration significantly interferes with coagulation as-says. The aim of the study was to evaluate the effect of DOACs and DOAC-Remove® on coagulation assays dur-ing thrombophilia testing. Methods. The study was car-ried out from January 2019 to the end of June 2020. It in-cluded 30 DOAC-treated patients, 14 females and 16 males aged 23 to 63 (median age 47.6 years), tested for thrombophilia due to venous thromboembolism (VTE). Thrombophilia testing was performed using DOAC-Remove® tablets (activated charcoal). The results before and after DOAC-Remove® were compared. Results. Posi-tive lupus anticoagulant (LA) results were observed in 20% apixaban, 100% dabigatran, and 70% rivaroxaban-treated patients, while in samples after DOAC-Remove®, the LA positivity was observed only in one from the apix-aban group. Before DOAC-Remove®, the activated pro-tein C (APC) resistance (APC-R) was measurable in 40% dabigatran and 80% rivaroxaban-treated patients, while, after using DOAC-Remove®, the APC-R was measurable in all cases. Comparing the results obtained from the sam-ples before and after DOAC-Remove®, a difference was noted in relation to all dilute Russell's viper venom time (dRVVT) coagulation tests, except for the dRVVT ratio in the apixaban group. Clot-based methods for detecting the APC resistance were significantly affected by dabigatran and less by rivaroxaban. Conclusion. DOACs were prac-tically inactivated after the addition of the DOAC-Remove®, which made it possible to perform analyses for the LA and APC-R testing freely and obtain relevant re-sults., Uvod/Cilj. Primena direktnih oralnih antikoagulansa (DOAK)
značajno utiče na testove koagulacije. Cilj rada bio je da se pro-
ceni uticaj DOAK i DOAC-Remove® tableta (aktivni ugalj) na
testove koagulacije tokom ispitivanja trombofilije. Metode.
Istraživanjem, sprovedenim od januara 2019. do juna 2020.
godine, obuhvaćeno je 30 bolesnika lečenih DOAK-om i
testiranih na trombofiliju zbog venskog tromboembolzma
(VTE). Bilo je 14 žena i 16 muškaraca, starosti od 23 do 63
godine (medijana 47,6 godina). Ispitivanje trombofilije izvršeno
je upotrebom DOAC-Remove® tableta (aktivni ugalj).
Upoređivani su rezultati pre i posle primene DOAC-Remove®.
Rezultati. Pozitivni rezultati za lupus antikoagulantni (LA) test
dobijeni su kod 20% bolesnika lečenih apiksabanom, kod
100% bolesnika lečenih dabigatranom i kod 70% lečenih riva-
roksabanom, a u uzorcima posle DOAC-Remove® pozitivnost
na LA dobijena je samo kod jednog bolesnika iz grupe lečnih
apiksabanom. Pre primene DOAC-Remove®, rezistencija na
aktivisani protein C (activated protein C resistance – APC-R) bila je
merljiva kod 40% i 80% bolesnika lečenih dabigatranom, od-
nosno rivaroksabanom, dok je posle primene DOAC-
Remove®, APC-R bila merljiva u svim slučajevima.
Upoređivanjem rezultata dobijenih iz uzoraka pre i posle
primene DOAC-Remove®, primećena je razlika u odnosu na
sve testove vremena koagulacije izvršene razblaženim Russell-
ovim zmijskim otrovom (dilute Russell’s viper venom time –
dRVVT), osim dRVVT u grupi bolesnika lečenih apiksabanom.
Na koagulacionu metodu za otkrivanje APC-R značajno je uti-
cao dabigatran, a manje rivaroksaban. Zaključak. Nakon
primene DOAC-Remove® tableta, DOAK su praktično
inaktivisani što je omogućilo izvođenje analiza za LA i APC-R i
dobijanje relevantnih rezultata testova.",
publisher = "Inst. Sci. inf., Univ. Defence in Belgrade",
journal = "Vojnosanitetski Pregled",
title = "Influence of DOACS and DOAC-REMOVE® on coagulation assays during thrombophilia testing in DOAC-treated patients, Uticaj DOAK i DOAC-REMOVE® na testove koagulacije u toku testiranja
trombofilije kod bolesnika lečenih primenom DOAK",
volume = "79",
number = "12",
pages = "1248-1254",
doi = "10.2298/VSP210217101K"
}