Direct Oral Anticoagulants (DOACs) are now a commonly used anticoagulants and laboratory testing has become a routine procedure. Nodia works with different suppliers to provide hands on solutions for testing under specific patient conditions.
Hyphen BioMed took the lead in laboratory testing of DOACs. Hyphen BioMed provides kits for quantification of DOAC levels with great accuracy in patient plasma. The most commonly used kits for the purpose of direct oral anticoagulant testing are the HEMOCLOT Thrombin Inhibitor for Anti-IIa molecules and BIOPHEN Heparin LRT for the anti-Xa measurements. Until recently Hyphen’s anti Xa kit, BIOPHEN Heparin LRT, kit could not make a difference between heparin and DOACs. BIOPHEN DiXaI which is specific for anti-Xa DOACs was the best solution so far. Today it is possible to measure DOACs without influence of heparin with the BIOPHEN Heparin LRT by using a specially developed heparin inhibiting buffer. In order to comply with current regulations, Hyphen BioMed supplies CE-IVD marked applications for these methods on the most common coagulation analyzers.
For a rapid qualitative testing on the presence of DOACs in whole blood our partner Enicor developed active tip technology assays on their ClotPro thromboelastometer. The screening RVV-assay is based on an activation of coagulation by the Russel Viper Venom. In the presence of a DOAC the clotting time will be prolonged. A differentiation between anti-Xa and anti-IIa inhibitors can be made with a second test : the ECA-Test. Here the coagulation is activated with ecarin on the level of prothrombin. Only anti-IIa inhibitors will show a prolongated clotting time. The use active tip technology makes it very easy to perform the assay in emergency situations. Both assays are now CE-IVD labeled.
…and of course, if DOACs interfere with your laboratory assays, we have 5-Diagnostics to provide DOAC-Remove and DP-Filter to easily remove DOACs from the samples.