Algorithm for Rapid Exclusion of Clinically Relevant Plasma Levels of Direct Oral Anticoagulants in Patients Using the DOAC Dipstick:An expert consensus paper

With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (a) determine the potential contribution of the DOAC to spontaneous or trauma-induced hemorrhage; (b) identify appropriate candidates for reversal, or (c) optimize the timing of urgent surgery or intervention. The DOAC Dipstick test uses a disposable strip to identify factor Xa- or thrombin inhibitors in a urine sample. Based on the results of a systematic literature search followed by an analysis of a simple pooling of five retrieved clinical studies, the test strip has a high sensitivity and an acceptably high negative predictive value when compared with levels measured with liquid chromatography tandem mass spectrometry or calibrated chromogenic assays to reliably exclude plasma DOAC concentrations &gt;30ng/mL. Based on these data, a simple algorithm is proposed to enhance medical decision-making in acute care indications useful primarily in hospitals not having readily available quantitative tests and 24/7. This algorithm not only determines DOAC exposure but also differentiates between factor Xa- and thrombin inhibitors to better guide clinical management.</p

Cent scientifiques répliquent à SEA (Suppression des Expériences sur l’Animal vivant) et dénoncent sa désinformation

La lutte contre la maltraitance animale est sans conteste une cause moralement juste. Mais elle ne justifie en rien la désinformation à laquelle certaines associations qui s’en réclament ont recours pour remettre en question l’usage de l’expérimentation animale en recherche

The DOAC (direct oral anticoagulant) Dipstick reliably excludes residual FXa inhibitors levels in the preoperative setting

Highlights- Preoperative point-of-care test to determine DOAC levels in plasma- Comparison of the performance of a point-of-care test, UHPLC-MS/MS and a chromogenic assay- A negative DOAC Dipstick excludes residual levels of FXa inhibitors in plasma.- Reference standard test significantly impacts the performance of the index test. - Chromogenic anti-FXa assays should be validated against UHPLC-MS/MS

Corrigendum to "Asundexian in atrial fibrillation:Can pharmacodynamic data explain the failure?” [Thromb. Res. 236 (2024) 236–239 TR_8963, (S0049384824000732), (10.1016/j.thromres.2024.03.001)]

The authors regret that the final concentrations of tissue factor and phospholipids reported for the thrombin generation assay are incorrect. This information can be found on page 236, in the following paragraph: “Three different reagents were used: PPP Reagent Low (1 pM tissue factor (TF) [0.16 pM in final concentration]; 4 μM phospholipids (PL)), PPP Reagent (5 pM TF [0.80 pM in final concentration]; 4 μM phospholipids) and PPP Reagent High (20 pM TF [3.2 pM in final concentration]; 4 μM phospholipids). A fourth reagent was prepared by diluting the PPP Reagent Low 10-fold (0.1 pM TF [0.016 pM in final concentration]; 0.4 μM phospholipids).”. The correct version of this paragraph is: “Three different reagents were used: PPP Reagent Low (final concentrations: 1 pM tissue factor (TF), 4 μM phospholipids), PPP Reagent (5 pM TF, 4 μM phospholipids) and PPP Reagent High (20 pM TF, 4 μM phospholipids). A fourth reagent was prepared by diluting the PPP Reagent Low 10-fold (0.1 pM TF, 0.4 μM phospholipids)”. The authors would like to apologise for any inconvenience caused.</p

Expérimentation animale: la recette d'une polémique scientifique

La majorité du grand public accepte l’expérimentation animale à condition que celle-ci contribue à l’amélioration de la santé humaine et qu’aucune autre alternative n’existe. En face, les opposants décrédibilisent la recherche et stigmatise une profession à des fins idéologiques. Relevé de leurs arguments

La souris, le patient, et le faux expert. Décryptage d'une mystification.

La recherche sur animaux est actuellement encadrée de façon stricte en Wallonie comme dans toute l'Union Européenne (voir l'article de Marc Vandenheede publié dans le Vif). Cette législation et les contrôles qui y sont associés induisent de nombreuses contraintes pratiques, des charges administratives et des coûts financiers importants que les chercheurs seraient certainement heureux d'éviter s'il existait une alternative à l'expérimentation animale