Development and Evaluation of a Prototype of a Novel Clotting Time Test to Monitor Enoxaparin
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Dosing of the anticoagulant enoxaparin may result in bleeding following excessive doses or thrombosis if dose is too low. Rarely, anti-Xa activity is used to assess the dose for enoxaparin, but its utility to predict clotting or bleeding remains uncertain. We aimed to develop a clotting time test to monitor enoxaparin therapy.
A previously developed mathematical model of the coagulation network was used to identify suitable targets for monitoring enoxaparin therapy. In vitro experiments were then carried out to demonstrate proof of mechanism of the clotting time test activated by the new target activator.
Using the mathematical model, we identified Xa as a plausible activating agent for a clotting time test for enoxaparin. In vitro experiments showed a prolongation of the Xa clotting time of 4.6-fold in the presence of enoxaparin (0.5 IU/ml) where 10 nM Xa was used to activate clotting.
Using both simulations and in vitro experiments, we provide a proof of mechanism for the Xa clotting time (XaCT) test, which can be considered for further development to provide a biomarker of the effect of enoxaparin on the clotting system.
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- Development and Evaluation of a Prototype of a Novel Clotting Time Test to Monitor Enoxaparin
Volume 29, Issue 1 , pp 225-235
- Cover Date
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- Springer US
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- coagulation network
- low molecular weight heparins
- mathematical model
- Industry Sectors
- Author Affiliations
- 1. School of Pharmacy, University of Otago, P.O. Box 56, Dunedin, 9054, New Zealand
- 2. Department of Pathology, School of Medicine, University of Otago, Dunedin, New Zealand
- 3. Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Waratah, NSW, Australia
- 4. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia