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Volume 8 Journal of Clinical & Experimental Pathology Pathology Summit 2018
July 02-03, 2018
July 02-03, 2018 Bangkok, Thailand
15th Global Experts Meeting on
Pathology and Laboratory Medicine
The new trend in laboratory assay of NOACs
Sin Chun Fung
University of Hong Kong, China
New Oral Anti-Coagulants (NOACs) are getting more and more popular now and vast majority of patients are taking
NOACs as thrombo-prophylaxis now. The merits of NOACs include wide therapeutic index and stable pharmacokinetics
and hence there is no need for laboratory monitoring. However, there are some clinical situations that laboratory monitoring
of NOACs is important for patient’s management; for example, patients undergoing invasive procedures or patients suffering
from bleeding complications. Various platforms of laboratory assay are available for measuring the drug level of dabigatran,
rivaroxaban and apixaban. The measurement of rivaroxaban and apixaban can be done by anti-Xa assay and dilute thrombin
time can be used to measure the level of dabigatran. Some review articles mentioned that the value of specific assay of NOACs
is uncertain, mainly because the precision and accuracy of the specific assay is not optimal, especially for low drug level.
Nowadays, some companies provide kit with low-level calibrators to improve precision of measurement of low drug level. In
our study, we use the anti-Xa kits and dilute thrombin time kits from Werfen Company and Sysmex Company for evaluating
the drug assay of dabigatran and rivaroxaban. The precision, accuracy, linearity and limit of detection are satisfactory for
measuring various levels of dabigatran and rivaroxaban, including low drug concentrations and the performance of the kits
provided by two companies are comparable. The relationship between the drug levels of NOACs with routine coagulation
screening tests was also evaluated. The issue of quality control and some practical issues for implementation of the specific
laboratory assay of NOACs will also be discussed.
Biography
Sin Chun Fung has obtained his Medical degree in 2008 and is a qualified Hematopathologist in Hong Kong. Currently he is working as a Clinical Assistant Professor
in University of Hong Kong. He had been working as Physician in the past. He is interested in the work and research in various hematological malignancies and
investigating the novel treatments. He is also passionate in the field of coagulating and hemostasis. With his experience and expertise in internal medicine, he had
done work on the laboratory assay of new oral anti-coagulants, with the aim of improving the management of patients taking NOACs.
Sin Chun Fung, J Clin Exp Pathol 2018, Volume 8
DOI: 10.4172/2161-0681-C2-048