在极低体重患者中,阿皮克萨班的抗Xa活性
Wanwarang Wongcharoen1, Amarase Pamarapa1, Siriluck Gunaparn1
1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Journal of clinical medicine
|August 14, 2025
概括
像阿皮克萨班这样的直接口服抗凝剂是预防血栓的首选. 这项研究发现,体重不足的患者的阿皮克萨班水平较高,这增加了超出治疗范围的风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 血栓形成的原因之一是血栓形成.
背景情况:
- 直接口服抗凝剂 (DOAC) 广泛用于血栓栓塞的预防.
- 关于极低体重 (BW) 个体的DOAC疗效和安全性的数据有限.
- 阿皮克萨班是一种常见的处方DOAC,需要在不同的患者群体中进行调查.
研究的目的:
- 为了评估apixaban在患者中的抗Xa (抗FXa) 活性.
- 为了比较正常体重 (>50公斤) 和体重不足 (≤50公斤) 患者之间的阿皮克萨班活性.
- 为了确定超出治疗性阿皮克萨班度的潜在预测因素.
主要方法:
- 一项针对150名因心房,静脉血栓栓塞或心内血栓而接受阿皮克萨班的患者的前性研究.
- 在治疗至少一周后,测量高峰 (Cpeak) 和低谷 (Ctrough) 度的抗FXa活性.
- 在正常体重和体重不足的患者群体之间对药物水平的统计比较.
主要成果:
- 总体而言,87.3%和84.7%的患者在预期的治疗范围内出现了Ctrough和Cpeak.
- 体重不足患者的平均Ctrough和Cpeak比正常的BW患者高得多.
- 低BW是超过指定Cpeak范围的唯一独立预测因素 (aOR 4.87,p=0.018).
结论:
- 大多数患者都达到治疗性阿皮克萨班水平.
- 体重较低的患者有更高的风险超过阿皮克萨班治疗度的上限.
- 进一步的研究可能是有必要的,以优化在体重不足的人群中的阿皮克萨班剂量.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
903
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
903
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
Venous Thrombosis III: Interprofessional Care
22
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
22
Therapeutic Index
5.1K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
5.1K
Factors Affecting Drug Distribution: Miscellaneous Factors
522
Drug distribution in the human body is a complex process influenced by various individual factors, including age, pregnancy, obesity, diet, body water composition, pH levels, and specific disease conditions.
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
522
Factors Affecting Protein-Drug Binding: Protein-Related Factors
254
Drug binding to proteins is a key aspect of pharmacokinetics and can influence a drug's distribution, absorption, and elimination in the body. Several factors, including the drug's physiochemical properties, protein concentration, disease states, and the number of binding sites on the protein, influence this process.
The physicochemical properties of a drug play a significant role in its ability to bind to proteins. Lipophilic drugs, which dissolve in fats, oils, and lipids, can be...
The physicochemical properties of a drug play a significant role in its ability to bind to proteins. Lipophilic drugs, which dissolve in fats, oils, and lipids, can be...
254


