%0 Journal Article %T Potential usefulness of activated charcoal (DOAC remove®) for dRVVT testing in patients receiving Direct Oral AntiCoagulants %+ Innovations thérapeutiques en hémostase (IThEM - U1140) %+ Recherche clinique appliquée à l'hématologie ((EA_3518)) %+ CHU Pontchaillou [Rennes] %+ Hôpital Raymond Poincaré [AP-HP] %+ Biostatistique, traitement et modélisation des données biologiques (BioSTM - EA 7537) %+ Biologie Intégrative du Tissu Osseux (LBTO) %+ Centre d'Investigation Clinique [Rennes] (CIC) %A Jourdi, G. %A Delrue, M. %A Stepanian, A. %A Valaize, J. %A Foulon-Pinto, G. %A Demagny, J. %A Duchemin, J. %A Nedelec-Gac, F. %A Darnige, L. %A Curis, E. %A Delavenne, X. %A Gaussem, P. %A Siguret, V. %A Gouin-Thibault, I. %< avec comité de lecture %@ 0049-3848 %J Thrombosis Research %I Elsevier %V 184 %P 86-91 %8 2019-12 %D 2019 %R 10.1016/j.thromres.2019.11.001 %M 31710863 %K Lupus anticoagulant %K Dabigatran %K Rivaroxaban %K Apixaban %K Antiphospholipid syndrome %Z Life Sciences [q-bio]/Human health and pathology/HematologyJournal articles %X Introduction Lupus Anticoagulant testing using dilute Russell Viper Venom Time (dRVVT) is challenging in patients receiving Direct Oral AntiCoagulants (DOAC) due to potential false positive results. In a multicenter study, we evaluated the in vitro removal of DOAC by activated charcoal (DOAC remove®), allowing reliable dRVVT testing. Materials and methods Patient samples were analyzed before and after treatment with DOAC remove® 49 apixaban, 48 rivaroxaban, 24 dabigatran and 30 none. DOAC plasma concentrations were measured using anti-Xa or diluted thrombin time assays. In a subset of 28 samples, DOAC concentrations were also measured using HPLC-MS/MS following treatment with DOAC remove®. DRVVT was performed using STA-Staclot dRVVT Screen®/Confirm® (Stago) or LAC-Screening®/Confirmation® (Siemens). Results Baseline median [min-max] concentrations were 94 [<20–479] for apixaban, 107 [<20–501] for rivaroxaban and 135 ng/mL [<20–792] for dabigatran; dRVVT screen ratio/confirm ratio was positive in 47, 90 and 42% of apixaban, rivaroxaban and dabigatran samples. Treatment with DOAC remove® did not affect dRVVT results in non-DOAC patients while it resulted in DOAC concentrations <20 ng/mL in 82, 98 and 100% of samples, respectively. Concentrations were <5 ng/mL with HPLC-MS/MS in 5 out of 10, 8 out of 10 and 7 out of 8 samples, respectively. DOAC remove® corrected DOAC interference with dRVVT assays in 76, 85 and 95% of the patients, respectively. Conclusion For dRVVT testing in DOAC patients, we suggest the use of DOAC remove® for every rivaroxaban sample, whereas it might only be used in positive apixaban and dabigatran samples. A residual DOAC interference cannot be ruled out in case of persisting dRVVT positive results after treatment with DOAC remove®. © 2019 Elsevier Ltd %G English %2 https://univ-rennes.hal.science/hal-02397750/document %2 https://univ-rennes.hal.science/hal-02397750/file/Jourdi%20et%20al-2019-Potential%20usefulness%20of%20activated%20charcoal%20%28DOAC%20remove%C2%AE%29%20for%20dRVVT%20testing%20in.pdf %L hal-02397750 %U https://univ-rennes.hal.science/hal-02397750 %~ INSERM %~ UNIV-ST-ETIENNE %~ UNIV-PARIS5 %~ UNIV-PARIS7 %~ UNIV-RENNES1 %~ APHP %~ HL %~ CIC %~ CIC203 %~ STATS-UR1 %~ UR1-UFR-SVE %~ UR1-HAL %~ USPC %~ UR1-SDV %~ TEST-UR-CSS %~ UNIV-RENNES %~ UDL %~ UNIV-PARIS %~ UP-SANTE %~ UR1-BIO-SA