Perosphere: Current Challenges in Measuring Anticoagulation

Monday, October 9
11:30 am – 12:15 pm
Location: Expert Theater 2

Speaker

Jack E. Ansell, MD, MACP, clinical investigator with a principal focus on the clinical problems of thrombosis, antithrombotic therapy, and the application of new modes of delivering and monitoring anticoagulants.

Theater Information

Anticoagulants are the number one class of drugs responsible for bringing people to hospital emergency departments because of adverse reactions (major bleeding), based on data from the Center for Disease Control & Prevention. Although the risk of bleeding with Direct Oral Anticoagulants (DOACs) is less than with warfarin, the DOACs (apixaban, rivaroxaban) are in the top ten list of drugs causing adverse events. When patients present, the emergency physician must determine what DOAC they are on, when it was last taken, what the renal function is, and most importantly, how impaired their coagulation system is. Unfortunately, routine coagulation assays (e.g., PT and aPTT) are unreliable in ruling out the presence of drugs. More specifically, sensitive assays (e.g., anti-FXa activity) are not widely available, and when they are, the turnaround time is often an hour or more. What is needed is a sensitive, rapid point-of-care (POC) assay that can specifically rule out the presence of significant drug levels. New technology has been developed that will make such an assay possible and fill a significant gap in the diagnostic and therapeutic management of patients with major or life-threatening bleeding on anticoagulants. We will review data comparing manual whole blood clotting time (Lee-White clotting time) to the POC assay and consider what this means for clinical practice. This technology is approved for use in the EU but has not yet been cleared in the United States.

Presented by Perosphere