{"title":"评估接受依诺肝素预防的肾清除率增强患者的抗Xa因子水平：一项探索性试点研究。","authors":"Zahra Sahraei, Azadeh Eshraghi, Saghar Barati","doi":"10.4103/jrpp.jrpp_11_25","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin's enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor X<sub>a</sub> levels in patients with augmented renal clearance (ARC) receiving enoxaparin prophylaxis.</p><p><strong>Methods: </strong>Forty patients aged 18 years or older receiving 40 mg of enoxaparin for deep vein thrombosis prophylaxis with a high ARC score were observed. ARC was confirmed by creatinine clearance exceeding 130 mL/min. Exclusion criteria included various conditions impacting hemostasis. The objective was to assess antifactor X<sub>a</sub> levels 4 h after the fourth dose of enoxaparin administration using a chromogenic assay.</p><p><strong>Findings: </strong>The mean ± standard deviation of the antifactor X<sub>a</sub> levels was 0.28 ± 0.21. A significant number of participants (65%) had suboptimal antifactor X<sub>a</sub> levels.</p><p><strong>Conclusion: </strong>The prophylactic use of enoxaparin in patients with ARC may result in insufficient antifactor X<sub>a</sub> levels. Although the mean levels were within the target range, many individuals did not reach the target level. Healthcare providers should consider renal function and ARC when prescribing enoxaparin to prevent thromboembolic events.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"14 1","pages":"35-38"},"PeriodicalIF":0.7000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237168/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluating Anti-factor X<sub>a</sub> Levels in Patients with Augmented Renal Clearance Receiving Enoxaparin Prophylaxis: An Exploratory Pilot Study.\",\"authors\":\"Zahra Sahraei, Azadeh Eshraghi, Saghar Barati\",\"doi\":\"10.4103/jrpp.jrpp_11_25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin's enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor X<sub>a</sub> levels in patients with augmented renal clearance (ARC) receiving enoxaparin prophylaxis.</p><p><strong>Methods: </strong>Forty patients aged 18 years or older receiving 40 mg of enoxaparin for deep vein thrombosis prophylaxis with a high ARC score were observed. ARC was confirmed by creatinine clearance exceeding 130 mL/min. Exclusion criteria included various conditions impacting hemostasis. The objective was to assess antifactor X<sub>a</sub> levels 4 h after the fourth dose of enoxaparin administration using a chromogenic assay.</p><p><strong>Findings: </strong>The mean ± standard deviation of the antifactor X<sub>a</sub> levels was 0.28 ± 0.21. A significant number of participants (65%) had suboptimal antifactor X<sub>a</sub> levels.</p><p><strong>Conclusion: </strong>The prophylactic use of enoxaparin in patients with ARC may result in insufficient antifactor X<sub>a</sub> levels. Although the mean levels were within the target range, many individuals did not reach the target level. Healthcare providers should consider renal function and ARC when prescribing enoxaparin to prevent thromboembolic events.</p>\",\"PeriodicalId\":17158,\"journal\":{\"name\":\"Journal of Research in Pharmacy Practice\",\"volume\":\"14 1\",\"pages\":\"35-38\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237168/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Research in Pharmacy Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jrpp.jrpp_11_25\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Research in Pharmacy Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jrpp.jrpp_11_25","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Evaluating Anti-factor Xa Levels in Patients with Augmented Renal Clearance Receiving Enoxaparin Prophylaxis: An Exploratory Pilot Study.
Objective: Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin's enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor Xa levels in patients with augmented renal clearance (ARC) receiving enoxaparin prophylaxis.
Methods: Forty patients aged 18 years or older receiving 40 mg of enoxaparin for deep vein thrombosis prophylaxis with a high ARC score were observed. ARC was confirmed by creatinine clearance exceeding 130 mL/min. Exclusion criteria included various conditions impacting hemostasis. The objective was to assess antifactor Xa levels 4 h after the fourth dose of enoxaparin administration using a chromogenic assay.
Findings: The mean ± standard deviation of the antifactor Xa levels was 0.28 ± 0.21. A significant number of participants (65%) had suboptimal antifactor Xa levels.
Conclusion: The prophylactic use of enoxaparin in patients with ARC may result in insufficient antifactor Xa levels. Although the mean levels were within the target range, many individuals did not reach the target level. Healthcare providers should consider renal function and ARC when prescribing enoxaparin to prevent thromboembolic events.
期刊介绍：
The main focus of the journal will be on evidence-based drug-related medical researches (with clinical pharmacists’ intervention or documentation), particularly in the Eastern Mediterranean region. However, a wide range of closely related issues will be also covered. These will include clinical studies in the field of pharmaceutical care, reporting adverse drug reactions and human medical toxicology, pharmaco-epidemiology and toxico-epidemiology (poisoning epidemiology), social aspects of pharmacy practice, pharmacy education and economic evaluations of treatment protocols (e.g. cost-effectiveness studies). Local reports of medication utilization studies at hospital or pharmacy levels will only be considered for peer-review process only if they have a new and useful message for the international pharmacy practice professionals and readers.
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