THROMBIN GENERATION ASSAY (TGA)

“Thrombin Generation Assay (TGA) – A Global standard assay for continuous hemostasis of Thrombin generation and inhibition“

Thrombin Generation Assay (TGA) is a test that comprehensively evaluates Thrombin formation, providing a comprehensive picture of potential blood coagulation, additional method to classical assay for clotting point detection. TGA allows to measure 100% of the amount of Thrombin produced, compared to a routine test that only shows 5%.

Therefore, TGA is being applied intensively in clinical monitoring and treatment relating to coagulation.

1. Aid in Bleeding Risk evaluation in severe heamophilia A and B

In heamophilia, there is discrepancies between clinical picture and factor VIII concentration assays. According to Dargaud (2005), patients with a severe clinical bleeding tendency usually had an ETP <50% of normal, independently from FVIII:C/FIX:C plasma concentrations.” (1)

Indeed, TGA facilitates individualized patient treatment approaches by individual variations in thrombin generation, which is essential in patients with deficiencies of rare blood clotting factor. Based on that, clinicians will appropriately adjust treatment strategies and regimens, optimize treatment effectiveness and minimize unwanted side effects.

2. Aid in Thrombotic Risk evaluation

TGA is a tool to monitor treatment response and dose adjustments in rare coagulation disorders such as thrombophilia disorder (AT deficiency, PC deficiency, PS deficiency, FV Leiden…) and recurrence of DVT.

3. Monitor effect of Antithrombotic Drugs on coagulation

TGA has a crucial role in monitoring treatment in patients receiving anticoagulants such as NOAC, LMWH, UFH or VKA.

Today, TGA plays an important role in promoting research, development and application relating to rare coagulation factor deficiencies. By elucidating the underlying mechanisms of hemostatic dysfunction and evaluating new therapeutic agents, TGA contributes to the development of innovative treatments. Furthermore, TGA serves as a valuable tool for clinical trials, providing objective data on treatment effectiveness and safety outcomes.

Review the webinar about TGA: “Is Thrombin generation just a research tool or a real aid in the management of hemophilia?”. https://www.stagowebinars.com/replay.php?idwebinar=107

TGA product information: https://medigroupasia.com/vi/xet-nghiem-y-khoa/ifu-brochures/

References:

1. Béguin, S. et. al. (2005). Evaluation of Thrombin generating capacity in plasma from patients with haemophilia A and B. Thrombosis and Haemostasis, 93(03), 475–480. https://doi.org/10.1160/th04-10-0706
2. Tripodi, A. (2016). Thrombin Generation Assay and Its Application in the Clinical Laboratory. Clinical Chemistry, 62(5), 699–707. https://doi.org/10.1373/clinchem.2015.248625
3. Gerotziafas, G. T. et. al. (2007). In vitro inhibition of Thrombin generation, after tissue factor pathway activation, by the oral, direct factor Xa inhibitor rivaroxaban. Journal of Thrombosis and Haemostasis, 5(4), 886–888. https://doi.org/10.1111/j.1538-7836.2007.02429.x

Pharm. Au Thanh Tu
April 11th, 2024