Evaluation of the Antithrombotic Effects of Rivaroxaban and Apixaban Using the Total Thrombus-Formation Analysis System: In Vitro and Ex Vivo Studies

Abstract

Background: The usefulness of the Total Thrombus-Formation Analysis System (T-TAS) for monitoring the anticoagulant effects of non-vitamin K oral anticoagulants (NOACs) in clinical practice has been poorly addressed.

Methods: NOACs (rivaroxaban and apixaban) were added to whole blood from healthy subjects in anin vitro study, and their effects on thrombus formation were evaluated by the T-TAS. We also evaluated antithrombotic effects usingex vivo samples of whole blood from patients given rivaroxaban or apixaban at the respective trough and peak drug concentrations.

Results: T-TAS could determine anticoagulant effects in whole blood treated with rivaroxaban or apixabanin vitro. The increases in the anticoagulant effects of rivaroxaban and apixaban from the trough to peak concentrations in whole blood were successfully monitored by the T-TAS usingex vivo samples. The antithrombotic effects of rivaroxaban and apixaban (in terms of factor Xa inhibition) at the peak were strongly linked to those at the trough.

Conclusion: T-TAS could be a clinically useful tool for monitoring the anticoagulant effects of factor Xa inhibitors, and may represent an accurate quantitative analysis.

J Clin Med Res. 2016;8(12):899-907
doi: http://dx.doi.org/10.14740/jocmr2773w