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Coagulation markers in patients with venous thromboembolism treated with 10 mg apixaban twice daily

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Abstract

Apixaban is used to treat venous thromboembolism (VTE) at 10 mg twice daily (BID) for 7 days, followed by 5 mg BID without dose adjustment, and non-valvular atrial fibrillation (NVAF) at 5 mg BID or 2.5 mg BID with dose adjustment criteria (DAC) including age, body weight, and renal function. The anti-factor Xa activity (AXA), prothrombin time (PT), and activated partial thromboplastin time (APTT) in patients with VTE receiving 10 mg BID of apixaban remains unclear. Twenty-six patients (70.8±15.4 years, 10 males) with VTE receiving 10 mg BID of apixaban were enrolled. The patients were divided into two groups based on whether they met the DAC of NVAF: DAC group (n=8) and non-DAC group (n=18). Trough and peak AXA values, PT, and APTT were measured at 10 mg BID dosage and then at 5 mg BID dosage. Coagulation markers in recipients of 10 mg BID therapy were significantly higher than those of 5 mg BID recipients. A significant and strong positive correlation was observed between AXA and PT at trough and peak times. The AXA values and PT in the DAC group were significantly higher than those in the non-DAC group. No significant inter-group differences were seen in APTT. This study provides the first report of AXA distribution in VTE patients receiving 10 mg BID of apixaban. Our findings indicate that coagulation markers may differ in patients with VTE-prescribed higher doses of apixaban and a DAC may be warranted in such patients.

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Data availability

The data that support the findings of this study are available from the corresponding author, R.O., upon reasonable request.

Abbreviations

APTT:

activated partial thromboplastin time

AXA:

anti-factor Xa activity

BID:

twice daily

DAC:

dose adjustment criteria

DOAC:

direct oral anticoagulant

FXa:

factor Xa

NVAF:

non-valvular atrial fibrillation

PT:

prothrombin time

VTE:

venous thromboembolism

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Acknowledgements

We would like to thank Editage (http://www.editage.com) for editing and reviewing this manuscript for English language.

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Authors and Affiliations

  1. Department of Cardiology, Matsudo City General Hospital, 993-1 Sendabori, Matsudo, Chiba, 247-8533, Japan

    Ryohei Ono, Kenichi Fukushima, Tatsuro Yamazaki, Daichi Yamashita, Hidehisa Takahashi & Yasuhiko Hori

  2. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Ryohei Ono

  3. Department of Neurology, Matsudo City General Hospital, 993-1 Sendabori, Matsudo, Chiba, 247-8533, Japan

    Kazutaka Nishimura

Authors
  1. Ryohei Ono
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  2. Kenichi Fukushima
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  3. Tatsuro Yamazaki
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  4. Daichi Yamashita
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  5. Hidehisa Takahashi
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  6. Yasuhiko Hori
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Contributions

All authors contributed to statistical analysis and writing of the study. R.O., K.F., and K.N. participated in study design, acquisition of the data, critical review, and wrote the manuscript; H.T. and Y.H. participated in acquisition of data and designed the research; T.Y. and D.Y. collected data and participated in the analysis and interpretation of data. The authors declare that all data were generated in-house and that no paper mill was used.

Corresponding author

Correspondence to Ryohei Ono.

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Ethics approval and consent to participate

This study was conducted in accordance with the ethics policies of Matsudo City General Hospital. This study protocol was approved by the Ethics Committee of Matsudo City General Hospital (Approval number 30-9 and 31-7).

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Not applicable.

Competing interests

The authors declare no competing interests.

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Ono, R., Fukushima, K., Yamazaki, T. et al. Coagulation markers in patients with venous thromboembolism treated with 10 mg apixaban twice daily. Naunyn-Schmiedeberg's Arch Pharmacol 395, 159–166 (2022). https://doi.org/10.1007/s00210-021-02190-3

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  • DOI: https://doi.org/10.1007/s00210-021-02190-3

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