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
{"title":"常规血液透析对阿哌沙班血药浓度的影响。","authors":"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","doi":"10.1111/hdi.13127","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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; <i>p</i> = 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 (<i>r</i> = 0.935, <i>p</i> = 0.000). Thus, anti-Xa activity might be used as a surrogate for apixaban plasma concentration.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>There seems to be no need for dose adjustments of apixaban; co-administration of LMWH next to apixaban might also be unnecessary.</p>\n </section>\n </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"28 1","pages":"72-76"},"PeriodicalIF":1.2000,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13127","citationCount":"0","resultStr":"{\"title\":\"Effect of conventional hemodialysis on the apixaban plasma concentration\",\"authors\":\"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\",\"doi\":\"10.1111/hdi.13127\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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; <i>p</i> = 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 (<i>r</i> = 0.935, <i>p</i> = 0.000). 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Effect of conventional hemodialysis on the apixaban plasma concentration
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.
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.
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