The Impact of Rivaroxaban and Apixaban on Tacrolimus Trough Levels
| Autor: | Crystal Franco-Martinez, Christina Long, Elisabeth Kincaide, Aileen C Scheibner, Reed Hall |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Pyridones Urology chemical and pharmacologic phenomena 030204 cardiovascular system & hematology Tacrolimus 03 medical and health sciences 0302 clinical medicine Rivaroxaban Pharmacokinetics medicine Humans 030212 general & internal medicine Retrospective Studies Transplantation business.industry Significant difference surgical procedures operative Pharmacodynamics Concomitant Pyrazoles Apixaban business Solid organ transplantation medicine.drug |
| Zdroj: | Progress in Transplantation. 31:236-241 |
| ISSN: | 2164-6708 1526-9248 |
| Popis: | The solid organ transplant community is slow to adopt the routine practice of using direct oral anticoagulants. Rivaroxaban and apixaban share common metabolic pathways with tacrolimus. This study aimed to clarify the impact of rivaroxaban/apixaban on tacrolimus troughs. Fifty solid organ transplant recipients with concomitant use of tacrolimus and rivaroxaban/apixaban were retrospectively assessed for changes in tacrolimus troughs and dose. Average dose-adjusted tacrolimus troughs and average tacrolimus total daily doses prior to and after rivaroxaban/apixaban initiation were compared. Subgroup analyses evaluating rivaroxaban and apixaban individually were performed. Rivaroxaban was prescribed to 18 recipients, and apixaban was prescribed to 32 recipients. Transplanted organs included kidney (n = 22), lung (n = 18), liver (n = 7), simultaneous pancreas and kidney (n = 1), and simultaneous kidney and liver (n = 2). The median doseadjusted tacrolimus trough and tacrolimus total daily dose prior to rivaroxaban/apixaban initiation was 2.15 ng/mL/mg (IQR 1.17, 3.37) and 4 mg (IQR 1.88, 6.25), respectively. The median dose-adjusted tacrolimus trough and tacrolimus total daily dose after rivaroxaban/apixaban initiation was 2.16 ng/mL/mg (IQR 1.24, 4.10) and 3.55 mg (IQR 1.5, 6.35), respectively. No significant difference was found between average dose-adjusted tacrolimus troughs or tacrolimus total daily doses before and after rivaroxaban/apixaban initiation or in the individual subgroup analyses for rivaroxaban/apixaban. It is unlikely that initiating rivaroxaban/apixaban affects tacrolimus troughs or requires tacrolimus dose adjustment. This study does not elucidate if tacrolimus affects rivaroxaban/apixaban pharmacokinetics or pharmacodynamics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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