title: [Non-VKA oral anticoagulants: an update for the clinical biologists].
abstract: Non-VKA oral anticoagulants (NOACs), thanks to their ease of use and their similar or superior safety/efficacy profiles versus warfarin, have now widely reached the lucrative market of anticoagulation. However, while the marketing authorization holders always claim, in a quite unclear way that no monitoring is required, accumulative evidence and cases of major bleeding have been described in the literature and reported by spontaneous reporting systems at the regulator's level. These compounds are usually given at fixed doses without routine coagulation monitoring. However, new data suggests that an assessment of the response at the individual level could improve the benefit-risk ratio of, at least dabigatran. Therefore, in certain patient populations, i.e. acute or chronic renal impairment or multiple drug interactions, measurement of drug exposure may be useful to ensure an optimal treatment response. More specific circumstances such as patients experiencing a haemorrhagic or thromboembolic event during the treatment duration, patients who require urgent surgery or an invasive procedure, or patient with a suspected overdose could benefit from such a measurement. This article aims at providing guidance on how to best estimate the intensity of anticoagulation using laboratory assays in daily practice.
authors: Département de pharmacie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), Université de Namur, Belgique, Laboratoire d'hématologie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), CHU Dinant-Godinne UCL Namur, Université Catholique de Louvain, Belgique.
authors: François
authors: F
authors: Mullier
authors: Département de pharmacie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), Université de Namur, Belgique.
authors: Jonathan
authors: J
authors: Douxfils
authors: Laboratoire d'hématologie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), CHU Dinant-Godinne UCL Namur, Université Catholique de Louvain, Belgique.
authors: Anne
authors: A
authors: Tamigniau
authors: Département de pharmacie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), Université de Namur, Belgique.
authors: Jean-Michel
authors: JM
authors: Dogné
authors: Groupe hospitalier Cochin-Broca-Hôtel-Dieu, Paris, France.
authors: Marie-Hélène
authors: MH
authors: Horellou
authors: Groupe hospitalier Cochin-Broca-Hôtel-Dieu, Paris, France.
authors: Claire
authors: C
authors: Flaujac
authors: Laboratoire d'hématologie, Namur thrombosis and hemostasis center (NTHC), Namur research institute for life sciences (Narilis), CHU Dinant-Godinne UCL Namur, Université Catholique de Louvain, Belgique.
authors: Bernard
authors: B
authors: Chatelain
authors: Laboratoire de biologie clinique, Clinique et maternité Sainte-Elisabeth, Namur, Belgique.
authors: Catherine
authors: C
authors: Goffinet
authors: Groupe hospitalier Cochin-Broca-Hôtel-Dieu, Paris, France.
authors: Meyer-Michel
authors: MM
authors: Samama
authors: Groupe hospitalier Cochin-Broca-Hôtel-Dieu, Paris, France.
authors: Isabelle
authors: I
authors: Gouin-Thibault
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001695:Biology; D001780:Blood Coagulation Tests; D000069604:Dabigatran / Q000008:administration & dosage*; D006801:Humans; D011720:Pyrazoles / Q000008:administration & dosage*; D011728:Pyridones / Q000008:administration & dosage*; D000069552:Rivaroxaban / Q000008:administration & dosage*; D014812:Vitamin K
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; D014812:Vitamin K; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran
keywords: NOAC; anticoagulant; apixaban; coagulation; dabigatran; monitoring; rivaroxaban