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Table 2 In detail: NOAC sensitivity of different global coagulation tests in plasma

From: Global assays and the management of oral anticoagulation

  

Rivaroxaban

Apixaban

Dabigatran

  

In vivo therapeutic dose1

 

Acute VTE:

15 mg bid

10 mg bid

150 mg bid

Prophylaxis:

20 mg od

5 mg bid

150 mg bid

  

In vivo mean plasma concentration (Cmin-Cmax, μg/L)1

 

Acute VTE:

100 - 270

104 - 330

93 - 184

Prophylaxis:

45 - 250

50 - 128

93 - 184

  

In vitro effective concentration (μg/L)2

PT

– Innovin

399 ± 49

>800

596 ± 73

– Thromborel

392 ± 36

>800

554 ± 41

– Neoplastin

214 ± 36

>800

538 ± 47

modified PT

– mPT-Innovin

43 ± 3

190 ± 13

64 ± 6

– mPT-Thromborel

47 ± 3

80 ± 6

88 ± 10

APTT

– Actin FSL

254 ± 28

>800

190 ± 15

TGA

– Lag time

41 ± 5

93 ± 28

27 ± 7

– Peak thrombin

109 ± 5

121 ± 4

380 ± 71

– AUC

151 ± 36

327 ± 99

433 ± 71

TEG-TF

– R

28 ± 3

80 ± 17

16 ± 8

– Angle

263 ± 66

721 ± 73

484 ± 3

– MA

>800

>800

>800

  1. 1NOAC dose (od, once daily; bid, twice daily) currently advised for the treatment of acute venous thromboembolism (VTE) and the prophylactic treatment of VTE and atrial fibrillation [81,82] with mean NOAC concentration in plasma at steady state during treatment pre dose (Cmin) and 2 h post dose (Cmax) [83-85].
  2. 2Pooled normal citrated plasma was spiked with NOACs ranging from 0–800 μg/L plasma and subjected to PT APTT, TGA and TEG analysis. The modified PT (mPT) reagent consisted of a mixture of 1 volume thromboplastin reagent and 1.25 volumes 80 mM CaCl2 [85]. The TGA assay was with 5 pM TF and 4 μM phospholipids. The TEG-TF in plasma was with 10 pM TF and 4 μM phospholipids. Effective concentration (EC±50%) was defined as a 50% increase or decrease in assay parameter by the NOAC of interest as compared to incubations without NOAC. EC±50% values were obtained by interpolation and are given as mean ± SD of at least 3 determinations with the same plasma pool. Part of the data were taken from Dinkelaar et al. and detailed methods can be found in that study [32].