Effect of conventional hemodialysis on the apixaban plasma concentration.

Autor: Poel T; Department of Nephrology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., de Rouw N; Department of Pharmacy, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Péquériaux NCV; Department of Clinical Chemistry and Hematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., van de Kerkhof D; Department of Clinical Chemistry and Hematology, Catharina Hospital, Eindhoven, The Netherlands., Windsant AMAV; Department of Pharmacy, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., van Marum RJ; Department of Clinical Pharmacology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.; Department of Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands., Kerckhoffs APM; Department of Nephrology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.; Department of Geriatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Jazyk: angličtina
Zdroj: Hemodialysis international. International Symposium on Home Hemodialysis [Hemodial Int] 2024 Jan; Vol. 28 (1), pp. 72-76. Date of Electronic Publication: 2023 Nov 14.
DOI: 10.1111/hdi.13127
Abstrakt: 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.
(© 2023 The Authors. Hemodialysis International published by Wiley Periodicals LLC on behalf of International Society for Hemodialysis.)
Databáze: MEDLINE
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