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BC: Articoli scritti da E. Ascari

Il laboratorio e i nuovi anticoagulanti orali
Laboratory and new oral anticoagulants
B. Morelli  |  E. Ascari  | 
<p>Heparins and vitamin K antagonists are drugs of choice for treatment and&nbsp;prevention of thrombotic pathologies. These drugs have a considerable degree of safety and efficacy, but they may&nbsp;present certain drawbacks, as they require frequent laboratory monitoring (unfractionated heparins and anti-vitamin&nbsp;K) or intravenous or subcutaneous administration (low molecular weight heparins). Due to these reasons, several&nbsp;studies have been performed to identify new anticoagulant drugs with characteristics of safety, efficacy and possibility&nbsp;of oral administration and no need of laboratory monitoring. New direct oral anticoagulants (DOAs) have as direct&nbsp;target thrombin (factor IIa) or factor-Xa inhibition; their safety and efficacy have been investigated in several phase&nbsp;III studies. DOAs in most advanced stage of release are dabigatran, rivaroxaban and apixaban; the first drug is a&nbsp;direct thrombin inhibitor, the others are direct factor-Xa inhibitors. DOAs do not require routine laboratory monitoring&nbsp;due to their high dose-response predictability; there is, however, a necessity to measure their anticoagulant effect in&nbsp;some particular situations. In those situations, it is important for the laboratory to consider: 1) how DOAs can interfere&nbsp;in the measurement of basic and more specialistic coagulation parameters; 2) which tests are the most suitable to&nbsp;detect the presence of the new drug; 3) which tests are the most useful to measure the anticoagulant effect; 4) which&nbsp;tests are the most suitable to monitor the antagonizing effect of some drugs (&quot;reversal&quot;) in case of DOA overdose.</p>
Biochimica Clinica ; 37(4) 292-300
Documenti - Documents