![]() ![]() ![]() 12-16 Use of an international sensitivity index (ISI) specific for rivaroxaban reduced interassay variability, whereas conversion to an INR used for monitoring vitamin K antagonist (VKA) therapy increased variability and demonstrated reduced rivaroxaban responsiveness. 10-13 There was significant variability with respect to assay sensitivity depending on the thromboplastin reagent used. However, in patients receiving rivaroxaban, the effect on PT was modest and variable, with lower concentrations approximating trough levels (41-60 ng/mL) and higher concentrations approximating peak levels (219-305 ng/mL), which increased the PT by 6%–19% and 50%–135%, respectively. In plasma from patients receiving rivaroxaban and plasma spiked with rivaroxaban there was a linear, concentration-dependent prolongation of the PT. ![]() Correlation coefficients appeared lower in ex vivo patient samples (0.47-0.66) compared with spiked normal human plasma (0.99-1.00). Only 6 studies reported a correlation coefficient ( R 2) to describe the relationship between rivaroxaban levels and the PT, which varied from 0.47 to 1.00 ( Table 1). The effect of rivaroxaban on the PT was evaluated in 14 studies. ![]()
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