Management of apixaban anticoagulation in a patient requiring therapeutic plasma exchange: a case report and a literature review.

IF 1.5 4区医学 Q4 CHEMISTRY, MEDICINAL

Pharmazie Pub Date : 2024-08-01 DOI:10.1691/ph.2024.4550

A Pilková, J M Hartinger, I Malíková, V Satrapová, D Šťastná, V Tesař, O Slanař

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引用次数: 0

Abstract

Therapeutic plasma exchange (TPE) is used as an effective treatment modality for a variety of autoimmune disorders. Apart from its desired effect of removing pathological blood components, it also can remove coagulation factors and drugs. Currently, there is an insufficient amount of information regarding the use of direct oral anticoagulants in this setting. In this article, we present a case report of a patient with myasthenia gravis and chronic anticoagulation with apixaban who underwent a series of TPE while continuing apixaban treatment. We observed that only 10% of daily dose was removed by the procedure and plasma levels of apixaban corresponded with expected range. TPE was not associated with shortened drug plasma half-life. We did not observe any significant alteration of apixaban pharmacokinetics during the period of TPE therapy, as well as no thrombotic or bleeding events. This case report supports the use of apixaban in patients treated by TPE, nevertheless, to firmly establish apixaban efficacy and safety profile in this clinical setting further research is needed.

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需要进行治疗性血浆置换的患者的阿哌沙班抗凝管理：病例报告和文献综述。

治疗性血浆置换术（TPE）是治疗各种自身免疫性疾病的有效方法。除了清除病理血液成分的预期效果外，它还能清除凝血因子和药物。目前，有关在这种情况下使用直接口服抗凝剂的信息尚不充分。本文报告了一例患有肌无力并长期服用阿哌沙班进行抗凝治疗的患者的病例，该患者在继续服用阿哌沙班治疗的同时接受了一系列 TPE 治疗。我们观察到，该过程只清除了每日剂量的 10%，阿哌沙班的血浆水平符合预期范围。TPE 与药物血浆半衰期缩短无关。在 TPE 治疗期间，我们没有观察到阿哌沙班的药代动力学发生任何重大变化，也没有发生血栓或出血事件。本病例报告支持在接受 TPE 治疗的患者中使用阿哌沙班，然而，要确定阿哌沙班在这种临床环境中的疗效和安全性，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmazie 医学-化学综合

CiteScore

3.10

自引率

0.00%

发文量

审稿时长

1.2 months

期刊介绍： The journal DiePharmazie publishs reviews, experimental studies, letters to the editor, as well as book reviews. The following fields of pharmacy are covered: Pharmaceutical and medicinal chemistry; Pharmaceutical analysis and drug control; Pharmaceutical technolgy; Biopharmacy (biopharmaceutics, pharmacokinetics, biotransformation); Experimental and clinical pharmacology; Pharmaceutical biology (pharmacognosy); Clinical pharmacy; History of pharmacy.