Does proton pump inhibition change the on-treatment anti-Xa activity in xabans-treated patients with atrial fibrillation? A pilot study
Proton pump inhibition (PPI) reduces gastrointestinal bleeding on direct oral anticoagulants. However, PPI may affect dabigatran on-treatment levels; and there is no information regarding the effect of PPI on xabans on-treatment activity. Thus, the aim of this study was to determine the impact of PPI on therapeutic anti-Xa activity in rivaroxaban- and apixaban-treated patients with atrial fibrillation (AF). This single-centre pilot prospective study enrolled 77 consecutive xabans-treated patients (42 rivaroxaban-treated and 35 apixaban-treated patients) with AF. PPI was administrated in 44 patients. Trough and peak anti-Xa activity was assessed with factor Xa-calibrated anti-Xa chromogenic analysis. There were no significant differences in trough anti-Xa activity comparing PPI-treated patients and patients without PPI (80.5 ± 66.5 ng/mL in PPI group vs. 71.6 ± 64.1 ng/mL in non-PPI group, p = 0.57, Table 2). Similarly, there were no significant differences in peak anti-Xa activity between compared groups (175.2 ± 102.5 ng/mL in PPI group vs. 202.9 ± 84.1 ng/mL in non-PPI group, p = 0.21). This pilot study did not reveal significant changes in xabans on-treatment anti-Xa activity according the PPI status.
KeywordsProton pump inhibitors Xabans Rivaroxaban Apixaban Anti-Xa activity Atrial fibrillation
This study was supported by Research Project of Comenius University in Bratislava UK/386/2018 and by Research 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 that might be relevant to the contents of this manuscript.
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 patients agreed to participate in the research and signed informed consent for study participation.
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