Sun Hack Lee, Mijin Kim, Min Sun Kim, Jeongcheon Choe, Jinhee Ahn, Hyewon Lee, Junghyun Choi, Han Cheol Lee, Hyerim Kim, Kwang Soo Cha
{"title":"韩国房颤患者的真实阿哌沙班浓度。","authors":"Sun Hack Lee, Mijin Kim, Min Sun Kim, Jeongcheon Choe, Jinhee Ahn, Hyewon Lee, Junghyun Choi, Han Cheol Lee, Hyerim Kim, Kwang Soo Cha","doi":"10.1007/s44313-025-00089-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Apixaban is recommended for patients with atrial fibrillation. Although routine monitoring of plasma concentrations is not typically advised, factors such as ethnicity, sex, and comorbidities can influence these levels. Our study analyzed the plasma apixaban concentrations (PAC) in patients to explore whether these levels, along with underlying conditions, offer enhanced insights for risk stratification.</p><p><strong>Methods: </strong>This study analyzed 49 patients with atrial fibrillation who had been taking apixaban for over a month, examined factor Xa levels within 6 h post-administration, and correlated PAC with clinical characteristics such as age, body weight, estimated glomerular filtration rate (eGFR), presence of heart failure, and bleeding events.</p><p><strong>Results: </strong>The mean plasma concentration of apixaban in all patients was 160.3 ± 77.5 ng/mL. Those taking apixaban 5 mg twice daily had higher plasma concentrations than those taking 2.5 mg twice daily (191.2 ± 75.3 ng/mL vs. 137.2 ± 72.0 ng/mL, p = 0.014). Among the patients receiving a reduced dose, renal function and heart failure were significantly associated with plasma concentrations. No factors were associated with the plasma concentrations in patients receiving the standard dose. Notably, reduced-dose patients with heart failure had plasma concentrations comparable to those of individuals receiving the standard dose and exhibited a higher incidence of bleeding than the other groups.</p><p><strong>Conclusions: </strong>PAC measurement revealed that apixaban dosages, classified based on age, body weight, and eGFR, were generally effective. Nonetheless, heart failure may increase plasma levels and correlate with an increased bleeding risk in Korean patients on reduced doses. Therefore, tailoring apixaban prescriptions to account for heart failure and other comorbidities may enhance treatment efficacy.</p>","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":"60 1","pages":"39"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234948/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-world apixaban concentration in Korean patients with atrial fibrillation.\",\"authors\":\"Sun Hack Lee, Mijin Kim, Min Sun Kim, Jeongcheon Choe, Jinhee Ahn, Hyewon Lee, Junghyun Choi, Han Cheol Lee, Hyerim Kim, Kwang Soo Cha\",\"doi\":\"10.1007/s44313-025-00089-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Apixaban is recommended for patients with atrial fibrillation. Although routine monitoring of plasma concentrations is not typically advised, factors such as ethnicity, sex, and comorbidities can influence these levels. Our study analyzed the plasma apixaban concentrations (PAC) in patients to explore whether these levels, along with underlying conditions, offer enhanced insights for risk stratification.</p><p><strong>Methods: </strong>This study analyzed 49 patients with atrial fibrillation who had been taking apixaban for over a month, examined factor Xa levels within 6 h post-administration, and correlated PAC with clinical characteristics such as age, body weight, estimated glomerular filtration rate (eGFR), presence of heart failure, and bleeding events.</p><p><strong>Results: </strong>The mean plasma concentration of apixaban in all patients was 160.3 ± 77.5 ng/mL. Those taking apixaban 5 mg twice daily had higher plasma concentrations than those taking 2.5 mg twice daily (191.2 ± 75.3 ng/mL vs. 137.2 ± 72.0 ng/mL, p = 0.014). Among the patients receiving a reduced dose, renal function and heart failure were significantly associated with plasma concentrations. No factors were associated with the plasma concentrations in patients receiving the standard dose. Notably, reduced-dose patients with heart failure had plasma concentrations comparable to those of individuals receiving the standard dose and exhibited a higher incidence of bleeding than the other groups.</p><p><strong>Conclusions: </strong>PAC measurement revealed that apixaban dosages, classified based on age, body weight, and eGFR, were generally effective. Nonetheless, heart failure may increase plasma levels and correlate with an increased bleeding risk in Korean patients on reduced doses. Therefore, tailoring apixaban prescriptions to account for heart failure and other comorbidities may enhance treatment efficacy.</p>\",\"PeriodicalId\":46224,\"journal\":{\"name\":\"Blood Research\",\"volume\":\"60 1\",\"pages\":\"39\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234948/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Blood Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s44313-025-00089-z\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s44313-025-00089-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:阿哌沙班推荐用于房颤患者。虽然通常不建议常规监测血浆浓度,但种族、性别和合并症等因素可影响这些水平。我们的研究分析了患者的血浆阿哌沙班浓度(PAC),以探讨这些水平,以及潜在的条件,是否为风险分层提供了更好的见解。方法:本研究分析了49例服用阿哌沙班超过一个月的房颤患者,在给药后6小时内检测Xa因子水平,并将PAC与年龄、体重、估计肾小球滤过率(eGFR)、心力衰竭和出血事件等临床特征相关联。结果:所有患者的阿哌沙班平均血药浓度为160.3±77.5 ng/mL。阿哌沙班5 mg每日2次组血浆浓度高于2.5 mg每日2次组(191.2±75.3 ng/mL vs. 137.2±72.0 ng/mL, p = 0.014)。在接受减少剂量的患者中,肾功能和心力衰竭与血浆浓度显著相关。在接受标准剂量的患者中,没有与血浆浓度相关的因素。值得注意的是,低剂量心力衰竭患者的血浆浓度与接受标准剂量的患者相当,出血发生率高于其他组。结论:PAC测量显示,根据年龄、体重和eGFR分类的阿哌沙班剂量通常是有效的。尽管如此,心力衰竭可能会增加血浆水平,并与减少剂量的韩国患者出血风险增加有关。因此,调整阿哌沙班处方以考虑心力衰竭和其他合并症可能会提高治疗效果。
Real-world apixaban concentration in Korean patients with atrial fibrillation.
Purpose: Apixaban is recommended for patients with atrial fibrillation. Although routine monitoring of plasma concentrations is not typically advised, factors such as ethnicity, sex, and comorbidities can influence these levels. Our study analyzed the plasma apixaban concentrations (PAC) in patients to explore whether these levels, along with underlying conditions, offer enhanced insights for risk stratification.
Methods: This study analyzed 49 patients with atrial fibrillation who had been taking apixaban for over a month, examined factor Xa levels within 6 h post-administration, and correlated PAC with clinical characteristics such as age, body weight, estimated glomerular filtration rate (eGFR), presence of heart failure, and bleeding events.
Results: The mean plasma concentration of apixaban in all patients was 160.3 ± 77.5 ng/mL. Those taking apixaban 5 mg twice daily had higher plasma concentrations than those taking 2.5 mg twice daily (191.2 ± 75.3 ng/mL vs. 137.2 ± 72.0 ng/mL, p = 0.014). Among the patients receiving a reduced dose, renal function and heart failure were significantly associated with plasma concentrations. No factors were associated with the plasma concentrations in patients receiving the standard dose. Notably, reduced-dose patients with heart failure had plasma concentrations comparable to those of individuals receiving the standard dose and exhibited a higher incidence of bleeding than the other groups.
Conclusions: PAC measurement revealed that apixaban dosages, classified based on age, body weight, and eGFR, were generally effective. Nonetheless, heart failure may increase plasma levels and correlate with an increased bleeding risk in Korean patients on reduced doses. Therefore, tailoring apixaban prescriptions to account for heart failure and other comorbidities may enhance treatment efficacy.