Development of monitoring tests for residual coagulation activity in novel oral anticoagulants

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K08621
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Laboratory medicine
• Research Institution: Health Sciences University of Hokkaido
• Principal Investigator: Ieko Masahiro 北海道医療大学, 歯学部, 教授 (50250436)
• Co-Investigator(Kenkyū-buntansha): 高橋 伸彦 北海道医療大学, 歯学部, 准教授 (20372279)
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 抗凝固療法 / 新規経口抗凝固薬 / 血栓症

Outline of Final Research Achievements

Novel oral anticoagulants (NOAC) are considered unnecessary for monitoring tests, however the test that can indicate the excess and under-dosage of NOAC is necessary for effective anticoagulant therapy.
We developed Thrombin Inhibition Ratio (TIR) using Ecarin Clotting Time for dabigatran therapy. TIR correlated well with the blood dabigatran concentration (r2 = 0.66). Then, for direct oral factor Xa inhibitors (Xa-INH) therapy, we developed Ratio of inhibited thrombin generation (RITG) using dilute PT. RITG correlated with the blood concentration of each Xa-INH (Rivaroxaban: r2 = 0.51, Apixaban: 0.45, Edoxaban: 0.75). In samples with low value of TIR or RITG, there were many samples with increased thrombus markers such as FMC. TIR and RITG can reflect the excess and under-dosage of NOAC. Also, RITG is a unique test that can simultaneously evaluate the effects of three kinds of Xa-INH. We are planning to consider more effective NOAC therapy using these indexes in the future.

Free Research Field

血液内科