Advanced search
Publication Cover
British Journal of Biomedical Science Volume 76, 2019 - Issue 3
Journal homepage
520
Views
4
CrossRef citations to date
0
Altmetric
Articles

The rivaroxaban-adjusted normalized ratio: use of the prothrombin time to monitor the therapeutic effect of rivaroxaban

B KimDepartment of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea (South Korea)ORCID Iconhttp://orcid.org/0000-0003-4456-5612
ORCID Icon,
S JangDepartment of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea);Asan Clinical Research Center, Seoul, Republic of Korea (South Korea)Correspondence[email protected]
ORCID Iconhttp://orcid.org/0000-0002-0045-1747
ORCID Icon,
YJ LeeAsan Clinical Research Center, Seoul, Republic of Korea (South Korea)
,
N ParkAsan Clinical Research Center, Seoul, Republic of Korea (South Korea)
,
YU ChoDepartment of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea)
&
CJ ParkDepartment of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea)ORCID Iconhttp://orcid.org/0000-0003-4396-8348
ORCID Icon
Pages 122-128 | Received 12 Mar 2019, Accepted 28 Mar 2019, Published online: 17 Jun 2019
 
Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days

ABSTRACT

Background: The prothrombin time may be used to monitor the plasma concentration of rivaroxaban. However, there is variability in the responsiveness of rivaroxaban to different thromboplastins. We aimed to develop a rivaroxaban-monitoring method using the prothrombin time to reduce the differences in the sensitivity among reagents.

Methods: Rivaroxaban-spiked pooled normal plasma at a 0–1000 ng/ml concentration was used to generate a rivaroxaban-adjusted sensitivity index (SI) values, and was tested with three thromboplastins. The warfarin-adjusted international sensitivity index (ISI-warfarin), rivaroxaban-adjusted sensitivity index (SI-rivaroxaban), international normalized ratio (INR) calculated with ISI-warfarin, normalized ratio (NR) calculated with SI-rivaroxaban, and their coefficient of variances (CVs) were compared. The NR-rivaroxaban value was compared with the results of an anti-Xa assay.

Results: The ISI-warfarin and SI-rivaroxaban using different thromboplastins were 1.02 and 1.88, respectively, with Thromborel S, 0.90 and 1.00 using Recombiplastin 2G, and 1.30 and 1.15 using Neoplastin CI-plus. Between-thromboplastin variability expressed as CV were 6.3%–25.1% when expressed as INR-warfarin and 1.7%–4.7% when expressed as NR-rivaroxaban. CVs for the NR-rivaroxaban with another laboratory were significantly lower than those for INR-warfarin. Anti-Xa assay v NR-rivaroxaban correlation coefficients were 0.97–0.99.

Conclusion: Using a rivaroxaban-specific NR effectively minimises inter-thromboplastin variability. By utilizing a NR-rivaroxaban, standardized prothrombin time results could be rapidly obtained, especially useful in standardizing the therapeutic effect of rivaroxaban.

Summary Table

Table

Disclosure statement

No potential conflict of interest was reported by the authors.

Log in via your institution

Access through your institution

Log in to Taylor & Francis Online

Restore content access

Restore content access for purchases made as guest
There are no offers available at the current time.

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.