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6 protocols using rivaroxaban

1

Quantification of Dabigatran and Rivaroxaban

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Methanol and LC-MS-grade water were obtained from Fisher Scientific GmbH (Schwerte, Germany). Ammonium acetate, formic acid, and hydrochloric acid were purchased from Sigma-Aldrich (Deisenhofen, Germany). Dabigatran (the active form of Dabigatran etexilate), [13C6]-Dabigatran, rivaroxaban, and [13C6]-rivaroxaban were purchased from Alsachim (Strasbourg, France).
Primary stock solution of Dabigatran, [13C6]-Dabigatran, rivaroxaban, and [13C6]-rivaroxaban, each at a concentration of 10 mg/L, were prepared separately in Methanol/water (50:50) and stored at -20°C. Using drug-free citrate plasma, we prepared several calibrators (0.8, 1.6, 3.1, 6.3, 12.5, 25.0, 50.0, 100, 200, 400 and 800 μg/L of both Dabigatran and rivaroxaban) for the assay. Commercially available quality-control samples for Dabigatran and rivaroxaban purchased from Technoclone GmbH (Vienna, Austria) were used.
An internal standard solution including 20 μg/L [13C6]-Dabigatran, as well as 20 μg/L [13C6]-rivaroxaban, was prepared by mixing 1 ml [13C6]-Dabigatran stock solution, 1 ml [13C6]-rivaroxaban stock solution and 498 ml Methanol/water (90:10) containing 10 mmol/L hydrochloric acid.
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2

Quantifying Gene Expression Changes in Cell Stimulation

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To determine gene expression (CXCL8, VEGFA), 300 000 cells were seeded per 6‐well in regular culture medium. The following day, the medium was aspirated and replaced by serum‐free medium. After 24 h of serum starvation, cells were stimulated with FXa (Haematologic Technologies Inc., Essex Junction, VT) or thrombin (Enzyme Research Laboratories, South Bend, IN) in the presence or absence of rivaroxaban (Alsachim, Ilkirch Graffenstaden, France) or dabigatran (Alsachim). Cell lysate was collected in 1 mL Trisure (Trisure, Bioline, Taunton, MA).
Total RNA of all in vitro and in vivo samples was isolated from Trisure and converted to cDNA using Super Script II using manufacturer's instructions (ThermoFisher Scientific). The qPCRs were performed in a 10‐μL reaction, with SYBRselect master mix (Thermofisher Scientific), 20 ng cDNA template, and 200 nmol/L primers (see Table S1 for primer sequences), in a 384‐well‐qPCR plate on a CFX384 Touch Real‐Time PCR detection system (BioRad, Veenendaal, The Netherlands). After 10 minutes preheating at 95°C, 40 cycles were run of 15 seconds 95°C and 60 seconds 60°C. The C(t)‐values were obtained using a threshold of 150 relative units using BioRad CFX‐software. Technical triplicates were run for every sample.
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3

Quantification of Rivaroxaban and Isotopes

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Rivaroxaban and [13C6]-Rivaroxaban-d5 were purchased from Alsachim (Strasbourg, France).
G418 was purchased from Roche Applied Science (Vilvoorde, Belgium).
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4

Anticoagulant Factors Evaluation

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Recombinant TNF‐α was purchased from Life Technologies. Rivaroxaban and dabigatran (Alsachim) were weighed and dissolved in DMSO; aliquots were stored at −20°C. Recombinant hirudin was dissolved in H2O and stored at −20°C (LabNed). PPACK was obtained from Calbiochem (Merck Biosciences). Plasma‐derived α‐thrombin and corn trypsin inhibitor (CTI; final concentration 70 µg/ml) were obtained from Haematologic Technologies.
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5

Coagulation assay of anti-/procoagulants

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In vitro, pro-and anticoagulant drugs were added at a single, clinically relevant dose to the platelet-poor plasma samples, as outlined previously. 22 Procoagulants were added to the plasma samples derived from controls and study patients pre-LT and during LT. Anticoagulants were added to plasma samples derived from controls and patients pre-LT and post-LT.
The tested procoagulants were:
-Pooled normal plasma (PNP); final concentration 20%. To simulate FFP transfusion. (A generous gift from Dr. J.C.M. Meijers, Academic Medical Center Amsterdam, the Netherlands.) -The 4-factor PCC Cofact (Sanquin, Amsterdam, the Netherlands); final concentration 0.5 U/mL. The tested anticoagulants were:
-Dabigatran (Alsachim, Illkirch Graffenstaden, France); final concentration 300 ng/mL. -Rivaroxaban (Alsachim); final concentration 25 ng/mL. -Unfractionated heparin; final concentration 0.1 U/mL (Heparine Leo, Leo Pharma, Ballerup, Denmark).
-The LMWH Clexane (Sanofi-Aventis BV, Gouda, the Netherlands); final concentration 0.2 U/mL.
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6

Pharmacokinetics of Labeled Compounds

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H]estradiol 17b-D-glucuronide, and [ 3 H]cholecystokinin-8 (CCK8) were obtained from PerkinElmer (Waltham, MA). [ 3 H]1-methyl-4phenylpyridinium and [ 14 C]metformin were obtained from American Radiolabeled Chemicals, Inc. Dabigatran and [ 14 C]Dabigatran were synthesized by Boehringer Ingelheim Pharma GmbH (Ingelheim, Germany). Apixaban, [ 13 C, 2 H 7 ]apixaban, and [ 13 C 6 ]Rivaroxaban were purchased from Alsachim (Illkirch-Graffenstaden, France). Rivaroxaban was purchased from Alsachim for human transporter studies and from ChemScene (Monmouth Junction, NJ) for rodent transporter studies. All other chemicals were of the highest reagent grade available from commercial sources.
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