Printable version

Sang Thrombose Vaisseaux. Volume 23, Number 1, 8-17, Janvier 2011, Mini-revue

Résumé   Texte intégral

Author(s) : Isabelle Gouin-Thibault, Patrick Mismetti, Claire Flaujac, Xavier Delavenne, Silvy Laporte, Marie-Anne Loriot, Thomas Lecompte

Summary : Direct and selective thrombin (dabigatran etexilate) or factor Xa (rivaroxaban) inhibitors, are new anticoagulants orally bioavailable without requirement for drug monitoring. Their efficacy and safety have been tested in prevention and treatment of thromboembolism disorders. Although these drugs represent a significant improvement over currently available ones, it is not known whether the risk/benefit ratio established for patients included in clinical trials can apply to “special” populations such as older patients, patients with renal impairment and/or polypharmacy. Indeed, high inter-individual variability and clinically relevant drug interactions have been reported with both drugs. Moreover, due to their direct mechanism of action, both rivaroxaban and dabigatran interfere with commonly used clotting times (PT, aPTT, factor activity, thrombin time for dabigatran) and with more specialised coagulation tests such as lupus anticoagulant detection. Physicians in charge of patients treated with either drug have to be aware of this interference to interpret coagulation tests. A laboratory assay could thus be useful, to specifically measure drug activity in special situations and particular patients.

Keywords : orally available anticoagulants, rivaroxaban, dabigatran, laboratory tests