Pharmacokinetics of Apixaban Among Peritoneal Dialysis Patients

Rationale & ObjectiveThe efficacy and safety profile of apixaban remains uncertain in patients receiving peritoneal dialysis (PD) despite increasing use this population. Accordingly, we assessed the pharmacokinetics among PD.Study DesignA study a single center. Patients recruited received 1 week at 2.5 mg twice day to reach steady state. Serial blood samples were then taken before after last dose for analysis apixaban.Setting ParticipantsTen stable PD with atrial fibrillation an outpatient setting.Analytical Approach/OutcomesPharmacokinetic parameters including area under concentration-time curve from time 0 12 hours (AUC0-12), peak concentration, trough level, half-life, drug clearance analyzed.ResultsThere was wide variation range concentration across 10 patients. The AUC0-12 group significantly higher than those reported previously hemodialysis or healthy individuals. Three had supratherapeutic whereas 2 level as compared pharmacokinetic parameter individuals taking equivalent therapeutic dosage.LimitationsSmall sample size short duration limits ability ascertain true bleeding risk detect any clinical outcomes. Results may be limited Asian populations only.ConclusionsA proportion levels even when reduced dosage used. Given large interindividual monitoring should done if available. Otherwise, one start doses caution more frequent signs bleeding. PD. A apixaban. Ten setting. Pharmacokinetic analyzed. There dosage. Small only.