Dabigatran levels in omeprazole versus pantoprazole-treated patients with atrial fibrillation: is there a difference?
To the Editor:
Proton pump inhibition (PPI) administrated with dabigatran etexilate reduces the risk of gastrointestinal (GI) bleeding on long-term dabigatran therapy . However, we have previously demonstrated  that PPI (with omeprazole or pantoprazole) significantly reduces the trough and peak on-treatment levels in dabigatran-treated patients with atrial fibrillation (AF). Similar observation of significantly lower dabigatran levels in PPI-treated patients was subsequently published in Japanese patients with AF . Now, it is not entirely clear whether this is a “class effect” or a “drug effect.” In fact, there are differences in PPI pharmacokinetics, such as differences in bioavailability, elimination half-life, and metabolism, which may translate into differences in interaction . Therefore, we decided to compare the effect of omeprazole PPI versus pantoprazole PPI on dabigatran etexilate trough and peak levels in patients with AF.
We performed a pilot, prospective,...
This study was supported by project APVV (Slovak Research and Development Agency) 16-0020.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical approval and inform consent
This research was done according to ethical standards and was approved by the local ethical committee (Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava). The patient agreed to participate in the research and signed informed consent for study participation.
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