在心房的患者中,阿皮克萨班的最低度降低了功能
Fadiea Al-Aieshy1, Mika Skeppholm2, Jonas Fyrestam3
1Department of Medicine Solna, Karolinska Institutet & Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
|October 28, 2024
概括
在中度功能障碍患者中,阿皮克萨班的暴露显著更高,这表明需要监测. 在功能受损的患者中,可以考虑降低剂量,以确保安全性和有效性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
背景情况:
- 阿皮克萨班是一种直接的XA因子抑制剂,部分通过脏排出.
- 目前的固定剂量处方缺乏跨不同功能水平的治疗药物监测.
- 功能障碍中阿皮克萨班积累的可能性引发了安全问题,包括出血风险.
研究的目的:
- 测量不同阶段功能患者的阿皮克萨班最低度.
- 评估功能障碍对阿皮克萨班暴露的影响.
主要方法:
- 在心房的患者中,使用LC-MS/MS测量了阿皮克萨班的最低度.
- 患者被分为正常功能 (n=39),中度功能障碍 (n=40) 和严重功能障碍 (n=6) 组.
- 估计的膜过率 (eGFR) 用于评估功能.
主要成果:
- 与正常功能患者相比,中度功能障碍患者的阿皮克萨班最低度显著更高.
- 平均最低度为59.8 ng/mL (正常),128.9 ng/mL (中度损伤) 和81.7 ng/mL (严重损伤).
- 阿皮克萨班的最低度与功能 (eGFR) 有显著的相关性.
结论:
- 与正常功能相比,标准5毫克两日一次的阿皮克萨班剂量在中度功能障碍患者中的暴露量大约是两倍.
- 建议在中度降低功能的患者中对阿皮克萨班进行监测.
- 考虑降低剂量可能是合理的,以达到与正常功能患者相比的暴露水平.
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