Bruno Pougault: Lupus Anticoagulant Testing During DOAC Therapy
Bruno Pougault, Global Marketing Hemostasis Product Manager at HORIBA ABX SAS, shared a post on LinkedIn:
“Lupus anticoagulant: are we detecting the antibody… or the anticoagulant?
A key question for the hemostasis laboratory.
LA testing relies mainly on dRVVT and aPTT-based assays. But these assays are also sensitive to anticoagulants.
With DOACs, the consequence can be significant: false-positive AND false-negative LA results.
Current guidance favors testing without interfering anticoagulant activity whenever clinically feasible.
When this is impossible, the laboratory has several options:
- Sample at the lowest expected drug concentration
- Measure residual drug activity
- Understand the drug-reagent-analyzer interaction
- Consider validated DOAC-removal strategies
Recent real-world evidence adds an interesting perspective.
Among 701 DOAC-treated patients, 31 had positive confirmatory LA testing after DOAC removal. Of the 26 subsequently evaluated, all showed persistent aPL positivity at 12 weeks or more.
Promising? Yes.
Universal solution? Not yet.
Drug, concentration, reagent, analyzer and residual activity still matter.
How does your laboratory approach LA testing under DOAC therapy?
Share your practice.”
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