Pall T. Onundarson: The FIIX Test Receives Attention and A Call for Further Study at the ISTH 2026
Pall T. Onundarson, Professor Emeritus at Landspitali University Hospital, shared on LinkedIn:
”The FIIX Test received attention and a call for further study at the ISTH 2026 meeting.
Unfortunately, I couldn´t attend the meeting in Paris but I have listened to some replays, including the SSC meeting on VKA monitoring:
Emilie Belley-Côté, MD, PhD (McMaster University) said during her presentation (slightly paraphrased):
‘Vitamin K antagonists remain the only oral anticoagulants for certain conditions (MHV, RHD-AF, APLAS) but we need better ways to monitor VKA´s.
I´m very interested in this Fiix assay that monitors a specific FII and X normalized ratio (Fiix-NR) that is not dependent on the short acting factor VII that makes most of the INR variation. This test has only been studied sofar in Iceland and they have received very good results.
So this is something my group at McMaster is looking into studying in Canada and hopefully elsewhere as well in the future’
Steve Kitchen, PhD (Scientific Director of the UK National External Quality Assessment Scheme and the WHO International EQA Scheme for Blood Coagulation, Sheffield, UK) said during his presentation (also slightly paraphrased):
‘I think that the Fiix test is an attractive option for VKA monitoring that should be considered…and I think Mark Crowther and Karen Moffat at McMaster University [in fact also Emilie Belley-Côté, Daniel M. Witt and others] have some studies underway – perhaps you are involved?’
The improvement reported in the Fiix blinded randomized clinical trial (Onundarson PT et al., The Lancet Haematology, 2015) was achieved on top of all patients already receiving high-quality anticoagulation management using the DAWN OAC software.
According to Dr. Kitchen, an estimated 90 million people worldwide remain on VKAs.
Don´t they deserve the best monitoring available?
If monitoring can be improved, shouldn´t the medical community pursue it?”

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