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Anti-factor Xa activity, prothrombin time, and activated partial thromboplastin time in patients treated with factor Xa inhibitors

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Abstract

The regimens for factor Xa (FXa) inhibitors (apixaban, edoxaban, and rivaroxaban) vary with venous thromboembolism (VTE) or non-valvular atrial fibrillation (NVAF). The dosage and duration of FXa inhibitor therapy also differ. However, the distribution of anti-factor Xa activity (AXA) values, prothrombin time (PT), and activated partial thromboplastin time (APTT) in patients administered each FXa inhibitor has not fully been assessed. Trough and peak AXA values, PT, and APTT were measured in 85 patients taking apixaban, 105 patients taking edoxaban, and 27 patients taking rivaroxaban. The patients were further divided into three groups based on the dosage. Each FXa inhibitor showed various ranges of AXA values, and twice-daily use resulted in higher absolute AXA values than once-daily use. AXA values and PT for 20 mg apixaban at both trough and peak times were significantly higher than those for 5 mg or 10 mg. AXA values for 60 mg edoxaban at peak time were significantly higher than those for 15 mg or 30 mg. AXA values for 30 mg of rivaroxaban at both trough and peak times were significantly higher than those for 10 mg or 15 mg. In a nonlinear regression model of the relationship between AXA and PT or APTT, PT was positively correlated with AXA values for each FXa inhibitor. This study obtained trough and peak levels of AXA, PT, and APTT in patients with VTE or NVAF who were administered apixaban, edoxaban, and rivaroxaban.

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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

AXA:

Anti-factor Xa activity

APTT:

Activated partial thromboplastin time

CrCl:

Creatinine clearance

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 Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8670, Japan

    Ryohei Ono & Yoshio Kobayashi

  2. Department of Cardiology, Matsudo City General Hospital, 993-1 Sendabori, Matsudo City, Chiba, 270-2296, Japan

    Ryohei Ono, Hidehisa Takahashi, Yasuhiko Hori & Kenichi Fukushima

  3. Department of Neurology, Matsudo City General Hospital, 993-1 Sendabori, Matsudo City, Chiba, 270-2296, Japan

    Kazutaka Nishimura

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  1. Ryohei Ono
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  4. Yasuhiko Hori
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  5. Kenichi Fukushima
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Contributions

R.O. contributed to statistical analysis and writing of the study. K.F., and K.N. participated in study design, acquisition of the data, and critical review; H.T. and Y.H. participated in acquisition of data and designed the research; Y.K. critically revised the manuscript. 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

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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Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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The authors declare no competing interests.

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Ono, R., Nishimura, K., Takahashi, H. et al. Anti-factor Xa activity, prothrombin time, and activated partial thromboplastin time in patients treated with factor Xa inhibitors. Naunyn-Schmiedeberg's Arch Pharmacol 396, 323–336 (2023). https://doi.org/10.1007/s00210-022-02312-5

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