Real‐World Rivaroxaban and Apixaban Levels in Asian Patients With Atrial Fibrillation

Shin‐Yi Lin; Ching‐Hua Kuo; Shin‐Joe Yeh; Li‐Kai Tsai; Yen‐Bin Liu; Chih‐Fen Huang; Sung‐Chun Tang; Jiann‐Shing Jeng

doi:10.1002/cpt.1601

journal article Open Access Sep 14, 2019

Real‐World Rivaroxaban and Apixaban Levels in Asian Patients With Atrial Fibrillation

Shin‐Yi Lin Ching‐Hua Kuo Shin‐Joe Yeh Li‐Kai Tsai Yen‐Bin Liu Chih‐Fen Huang Sung‐Chun Tang Jiann‐Shing Jeng

Clinical Pharmacology & Therapeutics Vol. 107 No. 1 pp. 278-286 · Wiley

View at Publisher Save 10.1002/cpt.1601

Abstract

This study aims to measure the plasma levels of rivaroxaban and apixaban among Asian patients with atrial fibrillation and compare the results with expected drug levels from clinical studies. A total of 73 patients taking rivaroxaban and 105 patients taking apixaban were enrolled. Peak and trough levels were measured using ultra‐high performance liquid chromatography with tandem mass spectrometry. The percentage of those with drug levels within the expected range reported in clinical studies was significantly higher in the apixaban group than in the rivaroxaban group, both for trough (84.8% vs. 64.4%; P = 0.002) and peak levels (76.9% vs. 33.8%; P < 0.001). After adjusting for age, sex, kidney function, appropriate dose, and adherence, patients taking rivaroxaban were still less likely to have peak and trough levels within the expected drug levels. Our real‐world data suggests that Asian patients taking rivaroxaban are more likely to have out‐of‐expected drug levels than those taking apixaban.

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References

30

[1]

10.1016/j.joa.2017.05.004

[2]

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Craig T. January, L. Samuel Wann, Hugh Calkins et al.

Journal of the American College of Cardiology 10.1016/j.jacc.2019.01.011

[3]

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Paulus Kirchhof, Stefano Benussi, Dipak Kotecha et al.

European Heart Journal 10.1093/eurheartj/ehw210

[4]

10.1093/eurheartj/ehy136

[5]

10.2133/dmpk.dmpk-12-rg-034

[6]

10.1002/psp4.12347

[7]

10.1093/eurheartj/ehy807

[8]

10.1016/j.jacc.2013.07.104

[9]

10.1038/s41598-018-21884-y

[10]

10.1161/strokeaha.118.023877

[11]

10.1007/s40262-013-0100-7

[12]

Byon W. "Apixaban: a clinical pharmacokinetic and pharmacodynamic review" Clin. Pharmacokinet.

[13]

10.1161/jaha.117.008150

[14]

10.1016/j.jacc.2018.04.084

[15]

10.1253/circj.cj-12-0454

[16]

10.1161/strokeaha.116.013343

[17]

10.1016/j.annfar.2013.04.016

[18]

10.1007/s11239-018-1726-y

[19]

10.1016/j.cjca.2017.04.008

[20]

10.1177/1076029616631427

[21]

10.1016/j.ijcard.2016.04.082

[22]

10.1093/europace/euu311

[23]

10.1111/j.1365-2125.2009.03390.x

[24]

10.15420/aer.2017.50.1

[25]

10.3390/jpm9010007

[26]

10.1016/j.jfma.2018.11.013

[27]

10.1055/s-0038-1627480

[28]

Refining Clinical Risk Stratification for Predicting Stroke and Thromboembolism in Atrial Fibrillation Using a Novel Risk Factor-Based Approach

Gregory Y H Lip, Robby Nieuwlaat, Ron Pisters et al.

Chest 10.1378/chest.09-1584

[29]

10.1378/chest.10-0134

[30]

10.1253/circj.cj-12-0899

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30

References

Details

Published: Sep 14, 2019
Vol/Issue: 107(1)
Pages: 278-286
License: View

Authors

S

Shin‐Yi Lin

Department of Pharmacy National Taiwan University Hospital Taipei Taiwan; School of Pharmacy College of Medicine National Taiwan University Taipei Taiwan

C

Ching‐Hua Kuo

School of Pharmacy College of Medicine National Taiwan University Taipei Taiwan

S

Shin‐Joe Yeh

Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan

L

Li‐Kai Tsai

Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan

Y

Yen‐Bin Liu

Department of Internal Medicine Cardiovascular Center and Division of Cardiology National Taiwan University Hospital Taipei Taiwan

C

Chih‐Fen Huang

Department of Pharmacy National Taiwan University Hospital Taipei Taiwan; School of Pharmacy College of Medicine National Taiwan University Taipei Taiwan

S

Sung‐Chun Tang

Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan

J

Jiann‐Shing Jeng

Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan

Cite This Article

Shin‐Yi Lin, Ching‐Hua Kuo, Shin‐Joe Yeh, et al. (2019). Real‐World Rivaroxaban and Apixaban Levels in Asian Patients With Atrial Fibrillation. Clinical Pharmacology & Therapeutics, 107(1), 278-286. https://doi.org/10.1002/cpt.1601

Real‐World Rivaroxaban and Apixaban Levels in Asian Patients With Atrial Fibrillation

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