Ecarin based coagulation testing
Review published in Am J Hematol (2020)
Abstract
Ecarin is derived from venom of Echis carinatus, and will activate prothrombin into meizothrombin which will then cleave fibrinogen to result in clot formation. Ecarin based testing has been described for decades, but these assays were typically restricted to reference or speciality coagulation laboratories. This test was initially described for the assessment of direct thrombin inhibitors (eg, bivalirudin lepirudin, or argatroban) and was not affected by heparins or heparinoids. Ecarin based assays were rarely used for anticoagulation monitoring until the emergence of the direct oral thrombin inhibitor dabigatran etexilate in 2010. As this test was mentioned in the prescribing information for dabigatran etexilate, there was increased interest for use by clinical laboratories as the preferred method for assessing the anticoagulant effect of this drug. The purpose of this document is to review the current status of ecarin based assays for assessing dabigatran. This is with the understanding that these methods can also be exploited for determining the anticoagulation effect of parenteral direct thrombin inhibitors, such as argatroban and bivalirudin.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Review of ecarin-based coagulation assays initially developed for assessing leech-derived direct thrombin inhibitors (bivalirudin, lepirudin, argatroban), and subsequently exploited for dabigatran monitoring.
Por qué esto importa para la hirudoterapia
This review summarizes ecarin-based coagulation assays, noting that ecarin is derived from the venom of Echis carinatus and historically was used to assess direct thrombin inhibitors including bivalirudin, lepirudin, and argatroban. The review primarily addresses laboratory monitoring of dabigatran and notes that these methods can also determine the anticoagulation effect of parenteral direct thrombin inhibitors such as argatroban and bivalirudin. The abstract mentions lepirudin solely as one direct thrombin inhibitor whose effect could be assessed by ecarin-based testing and provides no information on leech biology, leech-derived substances, or hirudotherapy. No defensible connection to hirudotherapy or the leech secretome can be drawn from this abstract alone.
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026