<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Direct oral anticoagulants represent a significant group of drugs used in the prevention or treatment of venous thromboembolic events and stroke in patients with atrial fibrillation. Although routine therapy monitoring is not required, there is an increasing evidence that plasma levels may vary between individuals, suggesting the benefit of plasma levels measurement in some situations. Therapeutic drug monitoring is becoming more popular and accessible to the broader population. Introducing microsampling techniques for the quantitative collection of blood samples has arisen nowadays. The volumetric absorptive microsampling approach using a commercially available device such as a Mitra stick overcomes the hematocrit effect present in the dry blood spot technique. This review discusses the possible application of the volumetric absorptive microsampling approach in monitoring direct oral anticoagulant therapy efficacy.</p>
</abstract>

Direct oral anticoagulants represent a significant group of drugs used in the prevention or treatment of venous thromboembolic events and stroke in patients with atrial fibrillation. Although routine therapy monitoring is not required, there is an increasing evidence that plasma levels may vary between individuals, suggesting the benefit of plasma levels measurement in some situations. Therapeutic drug monitoring is becoming more popular and accessible to the broader population. Introducing microsampling techniques for the quantitative collection of blood samples has arisen nowadays. The volumetric absorptive microsampling approach using a commercially available device such as a Mitra stick overcomes the hematocrit effect present in the dry blood spot technique. This review discusses the possible application of the volumetric absorptive microsampling approach in monitoring direct oral anticoagulant therapy efficacy.

Volumetric Absorptive Microsampling Technique in the LC-MS Determination of Direct Oral Anticoagulants

Acta Medica Martiniana

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Direct oral anticoagulants represent a significant group of drugs used in the prevention or treatment of venous thromboembolic events and stroke in patients...

Drug class	Analytes
Antibiotics	cefepime, fosfomycin, linezolid, meropenem, tazobactam, vancomycin
Anticonvulsants	brivaracetam, carbamezpine, ethosuximide, lamotrigine, levetiracetam, phenytoin, rufinamide, topiramate, valproic acid
Immunosuppressants	cyclosporin A, everolimus, mycophenolic acid, tacrolimus, sirolimus
Cardiovascular drugs	acetylsalicylic acid, atenolol, lisinopril, simvastatin, valsartan
Endogenous compounds	HbA1c, gamma-hydroxybutyric acid

	Dabigatran	Apixaban	Edoxaban	Rivaroxaban
Target	free and clot-bound thrombin	factor Xa	factor Xa	factor Xa
Prodrug	yes	no	no	no
Bioavability	3 – 7%	50%	60%	80 – 100%
Protein binding	35%	85%	55%	90–95%
Dominant clearance	renal	hepatobiliary	hepatobiliary	hepatobiliary
T_max	1.5 – 3 hrs	3 – 4 hrs	1 – 2 hrs	2 – 3 hrs
Dosing frequency	twice daily	twice daily	once daily	once daily

	Molecular mass (Da)	Lipophilicity (LogP)	pKa	PSA (Å)
Apixaban	459.49	2.33	pKa^a = 13.12	110.77
Dabigatran	471.52	2.37	pKa^a = 11.51pKa^b = 4.24	150.22
Edoxaban	548.06	1.61	pKa^a = 11.08pKa^b = 7.23	136.62
Rivaroxaban	435.88	1.74	pKa^a = 13.6	88.18

Volumetric Absorptive Microsampling Technique in the LC-MS Determination of Direct Oral Anticoagulants

Pubblicato online: 20 apr 2023

Pagine: 23 - 31

Ricevuto: 07 mar 2023

Accettato: 12 mar 2023

DOI: https://doi.org/10.2478/acm-2023-0004

Parole chiave
direct oral anticoagulants, microsampling techniques, therapeutic drug monitoring, volumetric absorptive microsampling

© 2023 Kertys M. et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

Examples of drugs applicable for monitoring using the volumetric absorptive microsampling technique [17]

Selected pharmacokinetics characteristic of direct oral anticoagulants

Physiochemical properties of direct oral anticoagulants

Volumetric Absorptive Microsampling Technique in the LC-MS Determination of Direct Oral Anticoagulants

Pubblicato online: 20 apr 2023

Pagine: 23 - 31

Ricevuto: 07 mar 2023

Accettato: 12 mar 2023

DOI: https://doi.org/10.2478/acm-2023-0004

Parole chiavedirect oral anticoagulants, microsampling techniques, therapeutic drug monitoring, volumetric absorptive microsampling

© 2023 Kertys M. et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

Examples of drugs applicable for monitoring using the volumetric absorptive microsampling technique [17]

Selected pharmacokinetics characteristic of direct oral anticoagulants

Physiochemical properties of direct oral anticoagulants

Parole chiave
direct oral anticoagulants, microsampling techniques, therapeutic drug monitoring, volumetric absorptive microsampling