Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška c. 7, 1000, Ljubljana, Slovenia.
Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
Sci Rep. 2021 Mar 15;11(1):5920. doi: 10.1038/s41598-021-85318-y.
Dabigatran interferes with many coagulation tests. To overcome this obstacle the use of idarucizumab as an in vitro antidote to dabigatran has been proposed. The aim of this study was to test the effect of idarucizumab as an in vitro antidote to dabigatran in ex vivo plasma samples from routine clinical patients examined by a thrombin generation assay (TGA). From 44 patients with atrial fibrillation five blood samples were collected. Thrombin generation was measured in all samples before and after the addition of idarucizumab. When idarucizumab was added to baseline plasma (no dabigatran), it caused a significantly shorter Lag Time and Time to Peak Thrombin, and a higher Peak Thrombin and Endogenous Thrombin Potential (ETP) of TGA. Similar results were obtained when idarucizumab was added to dabigatran-containing plasma, with TGA parameters comparable to baseline + idarucizumab plasma, but not to baseline plasma. In summary, our study showed that in vitro addition of idarucizumab to plasma samples from patients increases thrombin generation. The use of idarucizumab to neutralize dabigatran in patient plasma samples as well as the clinical relevance of in vitro increased thrombin generation induced by idarucizumab needs further investigation.
达比加群会干扰许多凝血检测。为了克服这一障碍，已提出使用依达鲁单抗作为达比加群的体外解毒剂。本研究的目的是通过凝血酶生成试验（TGA）检测体外依达鲁单抗作为达比加群解毒剂在常规临床患者的血浆样本中的效果。从 44 名心房颤动患者中采集了 5 份血样。在添加依达鲁单抗之前和之后，所有样本均进行了凝血酶生成测量。当依达鲁单抗添加到基础血浆（无达比加群）中时，它会导致 TGA 的Lag Time 和达到最大凝血酶时间明显缩短，最大凝血酶和内源性凝血酶潜能（ETP）升高。当依达鲁单抗添加到含有达比加群的血浆中时，会得到类似的结果，TGA 参数与基础+依达鲁单抗血浆相当，但与基础血浆不同。总之，我们的研究表明，体外向患者的血浆样本中添加依达鲁单抗会增加凝血酶生成。在患者血浆样本中使用依达鲁单抗中和达比加群以及依达鲁单抗体外增加凝血酶生成的临床相关性还需要进一步研究。
