Comparison of Commercial Low Molecular Weight Heparin and Homemade Anti-Xa Calibrators to a Commercial Specific Anti-Xa Calibrator for Plasma Rivaroxaban Quantification by Anti-Xa Oral Anticoagulant Plasma Concentration Chromogenic Assay

Lab Med. 2023 Jul 5;54(4):400-405. doi: 10.1093/labmed/lmac137.

Abstract

Objective: The main concern about measuring the concentration of rivaroxaban by anti-Xa assay in some laboratories is the lack of a commercial specific calibrator in emergencies. Therefore, this study aimed at providing a homemade anti-Xa calibrator and commercial low molecular weight heparin (LMWH) anti-Xa calibrator.

Methods: The anti-Xa plasma concentration of rivaroxaban was measured in 70 patients using a commercial specific anti-Xa calibrator, a commercial LMWH anti-Xa calibrator, and a homemade anti-Xa calibrator.

Results: We demonstrated a significant correlation and agreement (P < .001) between LMWH-calibrated anti-Xa and the commercial specific calibrator. A significant correlation (P < .001) was found between homemade calibrated anti-Xa made by normal pooled plasma and that calibrated with a commercial specific drug. The nonspecific homemade and LMWH calibrators had excellent agreement (P < .001) and can be used interchangeably.

Conclusion: Our data showed that for estimating rivaroxaban concentrations, the LMWH calibrator could be used as an alternative calibrator in the anti-Xa assay.

Keywords: Anti-Xa; NPP; homemade calibrator made by spiked normal pooled plasma; laboratory; low molecular weight heparin; rivaroxaban.

MeSH terms

  • Anticoagulants / pharmacology
  • Blood Coagulation Tests
  • Factor Xa Inhibitors
  • Heparin, Low-Molecular-Weight*
  • Humans
  • Rivaroxaban*

Substances

  • Rivaroxaban
  • Heparin, Low-Molecular-Weight
  • Factor Xa Inhibitors
  • Anticoagulants