# Assessment of the Anticoagulation Activity of Apixaban – Reply –

Johanne Silvain

<figure><img src="image_1.png" /></figure>

## To cite this version:

Johanne Silvain. Assessment of the Anticoagulation Activity of Apixaban – Reply –. Circulation Journal, 2015, 79 (7), pp.1642-1642. 10.1253/circj.CJ-15-0487. hal-01259448

HAL Id: hal-01259448

https://hal.sorbonne-universite.fr/hal-01259448

Submitted on 20 Jan 2016

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_2.png" /></figure>

Distributed under a Creative Commons Attribution 4.0 International License
<figure><img src="image_3.png" /></figure>

Assessment of the Anticoagulation Activity
of Apixaban – Reply –

We thank Dr Gonçalves and Dr Araújo for their comments. We agree on several points that emphasize the messages that are delivered in our editorial.¹ First, that the stability of non-vitamin K antagonist oral anticoagulants is real medical progress, because it leads to safer and more efficient use of anticoagulant therapy, with the potential to save many lives as compared to vitamin K antagonists and without the need for routine coagulation monitoring. Second, that tests and anti-dotes are still needed in cases of emergency surgery or bleeding in order to provide anesthesiologists and surgeons the right tools to make the right decision in these critical situations. Third, that according to facilities, teams should gather and discuss protocols in accordance with the available tests and

their fast deliverability to the emergency team. As for apixa-
ban, measurement of drug concentration might indeed be
difficult to perform; however, each laboratory should work on
process in order to provide the specific anti-Xa test until an
easier choice of routine coagulation tests proves to be more
accurate and useful.

Reference

1. Silvain J, Hauguel M, Kerneis M, Collet JP, Montalescot G; for the ACTION Study Group. Measuring and reversing the effect of non-vitamin K antagonist oral anticoagulants (NOACs) [Editorial]. *Circ J* 2015; **79**: 289–291.

Johanne Silvain, MD, PhD

ACTION Study Group,
Institute of Cardiology, Pitié-Salpêtrière Hospital (APHP),
University Pierre et Marie Curie 6 (UPMC),
Paris, France

(Released online May 29, 2015)