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Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences

Tomáš Bolek1, Matej Samoš2, Ingrid Škorňová3

  • 1Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 036 59, Martin, Slovak Republic.

Drugs & Aging
|May 9, 2018
PubMed

Insights

Elderly patients with non-valvular atrial fibrillation (NV-AF) on reduced dabigatran doses show higher drug levels than younger patients on the same dose. These levels are comparable to younger patients on standard dabigatran doses.

Area of Science:

  • Pharmacology
  • Geriatrics
  • Cardiology

Background:

  • The prevalence of non-valvular atrial fibrillation (NV-AF) is increasing in the elderly population.
  • Pharmacokinetics of oral anticoagulants may differ in elderly patients.
  • This study investigates dabigatran levels in elderly NV-AF patients.

Purpose of the Study:

  • To assess dabigatran plasma concentrations in elderly patients with NV-AF.
  • To compare dabigatran levels between elderly and younger NV-AF patients on different dosage regimens.
  • To evaluate the impact of age on dabigatran pharmacokinetics.

Main Methods:

  • Pilot prospective post-marketing study design.
  • Inclusion of 21 elderly (≥75 years) and 29 younger (≤70 years) NV-AF patients.
  • Measurement of dabigatran trough and peak levels using Hemoclot® Thrombin Inhibitor Assay.

Main Results:

  • Elderly patients on reduced dabigatran (110 mg BID) had significantly higher trough (99.3 ± 73.6 ng/mL) and peak (173.4 ± 116.2 ng/mL) levels compared to younger patients on reduced doses (51.6 ± 25.6 ng/mL and 116.1 ± 19.1 ng/mL, respectively).
  • No significant differences in dabigatran levels were observed between elderly patients on reduced doses and younger patients on standard doses (150 mg BID).

Conclusions:

  • Elderly patients on reduced dabigatran regimens exhibit higher drug exposure than younger patients on similar reduced doses.
  • Dabigatran exposure in elderly patients on reduced doses is comparable to younger patients on standard doses.
  • These findings highlight potential pharmacokinetic differences in elderly patients requiring anticoagulation therapy.
Abstract

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