Impact of DOACs on haemostasis diagnosis: Review of the interference and discussion on devices able to remove these interferences

Details

Supervisors

DOUXFILS, Jonathan

Faculty

Faculté de pharmacie et des sciences biomédicales

Degree label

Master [120] en sciences pharmaceutiques

Abstract

Thromboembolic diseases are relatively common and known as global burden diseases as much concerning the fact to be a major cause of morbidity and mortality as to represent an important health care cost. Those diseases are multifactorial. They involve interactions between inherited and acquired thrombosis risks factor, also other risks factor. The treatment consists of anticoagulation therapy and within this therapeutic arsenal, the use of direct oral anticoagulants (DOACs) is increasing and recommended. Nevertheless, they are known to interfere with almost all clotting tests to varying degrees which may lead to false positive or false negative tests results and to unnecessary investigations, making it difficult to establish the etiopathology of the thrombosis, which has an impact on the determination the type of thrombosis and affect patient’s care. In fact, according to the type of thrombosis, the risk of recurrence, prophylaxis treatment, screening of family members and duration of treatment differ. It’s crucial to run the tests without DOACs interference in order to establish an accurate diagnostic just as in patients on anticoagulation therapy as in patients whom treatment history is unknown when tests are done. Misdiagnosis will have a major impact for the patient taking the treatment for too long (risk of bleeding) or too short (risk of recurrence). Thus, strategies have been developed in order to minimize the impact of such therapy but they also have been linked to interferences. That’s why the University of Namur developed a new device more ergonomic and reliable in order to obtain a plasma sample free of DOACs and thereby removing also their interferences on hemostasis tests.