Non-VKA Oral Anticoagulants: Accurate Measurement of Plasma Drug Concentrations.

Abstract:

:Non-VKA oral anticoagulants (NOACs) have now widely reached the lucrative market of anticoagulation. While the marketing authorization holders claimed that no routine monitoring is required and that these compounds can be given at fixed doses, several evidences arisen from the literature tend to demonstrate the opposite. New data suggests that an assessment of the response at the individual level could improve the benefit-risk ratio of at least dabigatran. Information regarding the association of rivaroxaban and apixaban exposure and the bleeding risk is available in the drug approval package on the FDA website. These reviews suggest that accumulation of these compounds increases the risk of experiencing a bleeding complication. Therefore, in certain patient populations such as patients with acute or chronic renal impairment or with multiple drug interactions, measurement of drug exposure may be useful to ensure an optimal treatment response. More specific circumstances such as patients experiencing a haemorrhagic or thromboembolic event during the treatment duration, patients who require urgent surgery or an invasive procedure, or patient with a suspected overdose could benefit from such a measurement. This paper aims at providing guidance on how to best estimate the intensity of anticoagulation using laboratory assays in daily practice.

journal_name

Biomed Res Int

authors

Douxfils J,Mani H,Minet V,Devalet B,Chatelain B,Dogné JM,Mullier F

doi

10.1155/2015/345138

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

345138

eissn

2314-6133

issn

2314-6141

journal_volume

2015

pub_type

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