Effect of dabigatran and rivaroxaban treatment on a prothrombinase-based assay for assessment of activated C protein resistance

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ABSTRACT

We present a report about the interference due to factor IIa and factor Xa direct oral inhibitors on activated C protein resistance ratio (APCr), evaluated with a prothrombinase-based assay, in a patient heterozygous for factor V Leiden treated first with dabigatran and then with rivaroxaban. In this patient dabigatran increased the APCr ratio to a degree compatible with values observed in homozygous wild-type carriers, thus causing a potential misdiagnosis. We also found that rivaroxaban therapy was effective in lowering the APCr ratio.

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