I've just been told by a hematologist that Warfarin does not effect the blood screen outcome. He said that Apixaban can but not Warfarin. An APS specialist advised that I should come off all anti-coagulants if I am to decided to repeat the screen.
Not sure who is correct and I find people arguing both ways online also.
Id be interested to know what others have been told?
Which if any can effect a Lupus Anticoagulant result and others? And In what way..false positives or false negatives?
My understanding from recent testing and diagnosis at UCLH in London is that it’s only the Lupus Anticoagulant which is impacted by warfarin. Some very specialist labs can even test for that - but not at most places. The other 2 antibodies can routinely be tested when taking warfarin
You can not test Lupus Anticoagulant after you have started Warfarin treatment for APS.
I can't comment on the warfarin point as I didn't take that but I did have to stop apixaban for a while to have another lupus anticoagulant test or the apixaban would have changed the results, my haematologist said
Did they say it would change the result to give a false positive or false negatives?
False negatives, I had to stop apixaban for 3 months before the LA test
I wonder why it needed to be 3 months. Surely it doesnt stay in the system for more than a few days.
It will affect only the LA test as this is a clotting time test.
However, your hematologist might have a way to do an additional step to over ride that- and get the correct clotting g time despite being on warfarin.
Usually only very advanced APS specialty hematologists offer this. ( for example the only hematologist I’ve ever had offer this is Prof Hannah Cohen.)
Thank you. I honestly doubt the hospital I'm with has this advanced analytical option and probably just that my haemo isn't on point!
Given it was the LA test I returned positive for originally (while on Apixaban and maybe just started Warfarin), I'll be as equally unsure about it's result.
Do you know if they say the inaccuracy tends to be a false positive or a false negative?
I don’t...
Also, I can post on here my test results from prof Cohen. ( I was negative for antibodies that testing period, but it shows the method.
)
Do you happen to know if she does private consultations? I can't seem to find her other than at the NHS hospital which would mean a very lengthy referral wait.
She does. ( well, as of May 2018 she did.)
I did hear she was limiting her private practice to only APS.
It was at the McMillan cancer center. That’s where I saw her.
Did you want me to post my labs?
I know different viper must be used when patient is on warfarin.
No warfarin in system- DRVV- dilute Russell Viper Venom
With warfarin in system- it’s an Asian viper I think- Kaolin . ( KCT) Kaolin clotting time.
Yes please
Yes she’s my consultant at UCLH
Looking this up I came across this:
rmdopen.bmj.com/content/6/1...
and
pubmed.ncbi.nlm.nih.gov/194....
Don're profess to understand it all!
I have heard that before, or rather read it but in my case it has not mattered. I've been on Coumadin and all three of my titers have come back triple positive for all three antibodies so that may mean that it could depend on the individual.
Hiya. I see haematologist at Guys hospital in London and there they can test for the lupus anticoagulant whilst taking warfarin. Apparently they use a type of snake venom !! All amazing stuff but they test me every 6 months. Well, they did until coronavirus! The haematologist local to me, thankfully knew there was some way for it to be tested and rang a couple of pathology labs who all said no, but she persevered and checked with Guys who said yes, so she referred me to London.
Hiya. Thanks for replying. Where abouts are you? I did see Dr Kaur privately around 2 months ago at London bridge and he advised to come off the Anticoags to retest!
I live in Warwickshire, at my first appointment at Guys I saw Karen Breen and when I told her what the haematologist here had said, she said yes we can do the test whilst you are on warfarin.
Ok that is really good to know. Not sure how I'll find it if the bloods done last week will be the right way or not. Do you know what needs to be done to make them Warfarin tolerant?
Not really sure, was told it was to do with snake venom, that it is added and it removes the warfarin 🥴
Pro Hughes answered in his q& a below
Hiya Witty. Forgive my ignorance but are you saying the Prof has or will answer this question? Do I need to ask it in the forum being created for the session or will a moderator ask it for me? Sorry just don't know how this all works.
Medication given for Aps
Lifelong Rivorxaban for APS
Apixaben What are the pros or cons
I need a clearer picture please.
