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Direct Oral Anticoagulant Transition Strategies Using Anti-Xa Concentrations Upon Intensive Care Unit Admission.

Mariah I Sigala1, Corey V Dinunno1, Chelsea N Lopez1

  • 1Department of Pharmacy, Houston Methodist Hospital, Houston, TX, USA.

The Journal of Pharmacy Technology : Jpt : Official Publication of the Association of Pharmacy Technicians
|September 12, 2025
PubMed
Summary

Using factor Xa inhibitor (FXaI) concentrations to guide anticoagulation transitions in the ICU did not reduce major bleeding or thromboembolic events. Further research is needed to standardize FXaI transition strategies for critically ill patients.

Keywords:
DOACICUanti-Xa levelanticoagulationtransition

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Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Hematology

Background:

  • Oral factor Xa inhibitors (FXaI) are increasingly used, raising interest in FXaI-specific anti-Xa concentrations.
  • Critically ill patients with end-organ dysfunction face bleeding risks from FXaI accumulation.
  • FXaI anti-Xa concentration-guided transitions are explored to mitigate bleeding risk.

Purpose of the Study:

  • To compare bleeding incidence in intensive care unit (ICU) admissions between concentration-guided and non-concentration-guided FXaI transition strategies.
  • To evaluate the impact of FXaI concentration monitoring on major bleeding and thromboembolic events.

Main Methods:

  • Retrospective chart review of 433 patients with FXaI exposure within 48 hours of ICU admission (January 2019 - May 2022).
  • Exclusion criteria included bleeding diagnosis on admission, non-FXaI anticoagulation, or recent surgery.
  • Primary outcome: major bleeding within 5 days of ICU admission; Secondary outcome: thromboembolic events.

Main Results:

  • No significant difference in major bleeding rates between concentration-guided (2.7%) and non-concentration-guided (3.6%) groups (P=0.79).
  • Thromboembolic complications were similar (1.6% vs 2.0%, P=1.00).
  • Concentration-guided transitions involved a longer time from last FXaI dose (29.9 hours vs 19.4 hours, P<0.01).

Conclusions:

  • Guiding anticoagulation transitions with FXaI concentrations did not affect major bleeding or thromboembolic complications in the ICU.
  • Standardized anti-Xa cutoffs and validated concentration-guided strategies are needed for critically ill patients.
  • Current evidence does not support routine use of FXaI concentrations for anticoagulation transitions in this population.