Effect of conventional hemodialysis on the apixaban plasma concentration

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2023-11-14 DOI:10.1111/hdi.13127

Tim Poel, Nikki de Rouw, Nathalie C. V. Péquériaux, Daan van de Kerkhof, Annemieke M.A. Vermeulen Windsant, Rob J. van Marum, Angele P. M. Kerckhoffs

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Abstract

Purpose

Apixaban is a factor Xa inhibitor used in patients undergoing hemodialysis treatment. The objective of this study is to investigate the effect of hemodialysis on apixaban plasma concentrations.

Methods

This observational study is on patients treated with apixaban 2.5 mg twice daily on conventional hemodialysis with standard low-molecular-weight heparin (LMWH) anticoagulation (nadroparin 3800–7600 IU). Plasma blood samples were collected before starting dialysis (t1), 2 h after starting dialysis (t2), and directly after dialysis (t3). Apixaban concentration was measured before and after dialysis. Anti-Xa activity was measured for all three samples.

Results

A significant difference was observed between the apixaban concentration before and after dialysis (mean before dialysis 141.03 ng/mL; mean after dialysis 102.71 ng/mL; p = 0.003). Nonetheless, both apixaban plasma concentrations and anti-Xa levels remained within the reference range. Anti-Xa levels had a strong correlation with the apixaban concentrations (r = 0.935, p = 0.000). Thus, anti-Xa activity might be used as a surrogate for apixaban plasma concentration.

Conclusion

There seems to be no need for dose adjustments of apixaban; co-administration of LMWH next to apixaban might also be unnecessary.

Abstract Image

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常规血液透析对阿哌沙班血药浓度的影响。

目的:阿哌沙班是一种用于血液透析治疗的Xa因子抑制剂。本研究的目的是探讨血液透析对阿哌沙班血药浓度的影响。方法:本观察性研究采用阿哌沙班2.5 mg，每日2次，常规血液透析患者联合标准低分子肝素(LMWH)抗凝(nadroparin 3800-7600 IU)。开始透析前(t1)、开始透析后2小时(t2)和透析后直接(t3)采集血浆血样。透析前后测定阿哌沙班浓度。测定了三种样品的抗xa活性。结果:透析前后阿哌沙班浓度差异有统计学意义(透析前平均141.03 ng/mL;透析后平均102.71 ng/mL;p = 0.003)。尽管如此，阿哌沙班血浆浓度和抗xa水平仍保持在参考范围内。抗xa水平与阿哌沙班浓度有较强相关性(r = 0.935, p = 0.000)。因此，抗xa活性可作为阿哌沙班血药浓度的替代指标。结论:阿哌沙班似乎无需调整剂量;低分子肝素与阿哌沙班的联合用药也可能是不必要的。

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

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.