Le suivi biologique du rivaroxaban : une revue de littérature.

Abstract

Rivaroxaban is a direct oral factor Xa inhibitor indicated for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Although routine monitoring of rivaroxaban is not necessary, laboratory measurement of its anticoagulant activity may be desirable in particular clinical situations. Objectif: Our first objective was to evaluate the usefulness of coagulation tests in evaluating the anticoagulant effect of Rivaroxaban in patients with non-valvular atrial fibrillation. We have also proceeded the development of Rivaroxaban follow-up register for patient on anticoagulant therapy. Method: PubMed and Science Direct were searched for studies that reported a relationship between coagulation tests and plasma concentrations of rivaroxaban. Results: We identified eight (08) eligible studies, prothrombin (PT) levels are less sensitive to rivaroxaban and normal PT cannot exclude clinically relevant rivaroxaban concentrations during treatment. Anti-Xa activity is linear over a wide range of drug concentrations (R2> 0 ,92) and can be used for the quantification of rivaroxaban concentrations. Our analysis did not show a significant difference in the measurement of anti-Xa activity in the different groups of patients studied in the articles, which diverges from the data reported by the literature on the existence of interindividual variability and this can be explained by several biases linked to the selection of articles. Conclusion: Rivaroxaban has varying effects on coagulation tests. Understanding these effects helps interpret test results in patients treated with rivaroxaban. More data is needed on the relationship between drug levels, results of coagulation tests and clinical outcomes in patients.