Detection of lupus anticoagulant in the presence of rivaroxaban using Taipan snake venom time.

摘要

According to the consensus classification criteria, an individual is diagnosed with the antiphospholipid syndrome (APS) when the following conditions are met: the persistent presence of circulating antiphospholipid antibodies and a history of thrombosis or pregnancy morbidity [1]. The dominant antigenic target recognized by the APS auto-antibodies is beta_2-Glycoprotein I (beta_2-GPI) [2]. The clinical manifestations correlate best with the prolongation of phospholipid-dependent clotting assays; the lupus anticoagulant (LAC) [3]. To prevent thrombotic complications, patients diagnosed with APS are maintained on anticoagulant treatment. This treatment itself prolongs clotting assays and therefore interferes with the detection of the LAC. There is no consensus on the treatment of patients with APS [4,5] and there is room for alternative treatment. One of the recently developed anticoagulants is rivaroxaban, a direct factor Xa (FXa) inhibitor [6]. Rivarox-aban has been developed for both prophylaxis and the treatment of thrombosis. Studies are ongoing to determine the efficacy of rivaroxaban in patients diagnosed with APS [7]. The aim of the present study was to study the interference of rivaroxaban in different assays developed for the detection of LAC.