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Journal of Thrombosis and Thrombolysis

, Volume 36, Issue 2, pp 187–194 | Cite as

Measuring the anticoagulant effects of target specific oral anticoagulants—reasons, methods and current limitations

  • Helen Mani
  • Alexander Kasper
  • Edelgard Lindhoff-Last
Article

Abstract

To simplify and optimize oral anticoagulation, new target-specific oral anticoagulants (TSOAs) have been developed. The direct thrombin-inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban are the first such compounds to receive approval in certain countries for various indications. Due to the predictable pharmacokinetic and pharmacodynamic profiles of these drugs, routine monitoring of patients receiving TSOA therapy has not been considered necessary. However, it has now been realized that in routine clinical settings, there are several situations where it may be prudent to assess the level of TSOA anticoagulation. Several studies evaluating the influence of TSOAs on various coagulation assays have been performed to identify systems that can be used to monitor these drugs. With a particular focus on dabigatran and rivaroxaban, we will describe and discuss the potential of several methods for measuring the anticoagulant effect of TSOAs, as well as their methodological limitations and the restrictions in transferring their results into clinical context.

Keywords

Rivaroxaban Dabigatran Coagulation assays Monitoring 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Helen Mani
    • 1
  • Alexander Kasper
    • 1
  • Edelgard Lindhoff-Last
    • 1
  1. 1.Division of Vascular Medicine, Department of Internal MedicineJohann Wolfgang Goethe-University Hospital Frankfurt/MainFrankfurtGermany

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