Cargando…
Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects?
The aim of this study was to improve knowledge of what happens in the coagulation of orthopaedic patients under rivaroxaban and apixaban, in order to finalize and cross-validate effective measurement methods and to provide arguments for helping to reference one or the other drug in our central pharm...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams And Wilkins
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664024/ https://www.ncbi.nlm.nih.gov/pubmed/26258673 http://dx.doi.org/10.1097/MBC.0000000000000371 |
_version_ | 1782403391978209280 |
---|---|
author | Freyburger, Geneviève Macouillard, Gérard Khennoufa, Karim Labrouche, Sylvie Molimard, Mathieu Sztark, François |
author_facet | Freyburger, Geneviève Macouillard, Gérard Khennoufa, Karim Labrouche, Sylvie Molimard, Mathieu Sztark, François |
author_sort | Freyburger, Geneviève |
collection | PubMed |
description | The aim of this study was to improve knowledge of what happens in the coagulation of orthopaedic patients under rivaroxaban and apixaban, in order to finalize and cross-validate effective measurement methods and to provide arguments for helping to reference one or the other drug in our central pharmacy. One hundred and two patients undergoing total hip or knee replacement were included. Half of them received rivaroxaban and the other half received apixaban. Blood samples (n = 244 with each drug) were taken at C(max) preoperatively and twice a week, apart from the day of the patient's discharge, when C(trough) concentration was targeted. Routine coagulation parameters, and functional and liquid chromatography tandem mass spectrometry assays for measurement of circulating concentrations were studied. The LC-MS/MS assay and the functional assays carried out in patients under routine conditions were highly correlated, apart from low concentrations (<30 ng/ml), which were affected by the variable individual potential to inhibit the exogenous bovine Xa used in the functional assays. After 1 week of treatment, the drugs differed: C(max) and C(trough) were closer when apixaban was taken twice daily (83 ± 39 and 58 ± 17 ng/ml) than with rivaroxaban taken once a day (113 ± 67 and 13 ± 20 ng/ml). Rivaroxaban had a greater influence on routine coagulation tests and reduced the maximum thrombin concentration more efficiently, as assessed by the thrombin generation test. Although rivaroxaban and apixaban present apparently similar constant rates, they exhibit significant differences in their concentrations and anticoagulant effects when studied ex vivo in orthopedic patients. |
format | Online Article Text |
id | pubmed-4664024 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Lippincott Williams And Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-46640242015-12-08 Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? Freyburger, Geneviève Macouillard, Gérard Khennoufa, Karim Labrouche, Sylvie Molimard, Mathieu Sztark, François Blood Coagul Fibrinolysis Original Articles The aim of this study was to improve knowledge of what happens in the coagulation of orthopaedic patients under rivaroxaban and apixaban, in order to finalize and cross-validate effective measurement methods and to provide arguments for helping to reference one or the other drug in our central pharmacy. One hundred and two patients undergoing total hip or knee replacement were included. Half of them received rivaroxaban and the other half received apixaban. Blood samples (n = 244 with each drug) were taken at C(max) preoperatively and twice a week, apart from the day of the patient's discharge, when C(trough) concentration was targeted. Routine coagulation parameters, and functional and liquid chromatography tandem mass spectrometry assays for measurement of circulating concentrations were studied. The LC-MS/MS assay and the functional assays carried out in patients under routine conditions were highly correlated, apart from low concentrations (<30 ng/ml), which were affected by the variable individual potential to inhibit the exogenous bovine Xa used in the functional assays. After 1 week of treatment, the drugs differed: C(max) and C(trough) were closer when apixaban was taken twice daily (83 ± 39 and 58 ± 17 ng/ml) than with rivaroxaban taken once a day (113 ± 67 and 13 ± 20 ng/ml). Rivaroxaban had a greater influence on routine coagulation tests and reduced the maximum thrombin concentration more efficiently, as assessed by the thrombin generation test. Although rivaroxaban and apixaban present apparently similar constant rates, they exhibit significant differences in their concentrations and anticoagulant effects when studied ex vivo in orthopedic patients. Lippincott Williams And Wilkins 2015-12 2015-10-30 /pmc/articles/PMC4664024/ /pubmed/26258673 http://dx.doi.org/10.1097/MBC.0000000000000371 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Original Articles Freyburger, Geneviève Macouillard, Gérard Khennoufa, Karim Labrouche, Sylvie Molimard, Mathieu Sztark, François Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title | Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title_full | Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title_fullStr | Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title_full_unstemmed | Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title_short | Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
title_sort | rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects? |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664024/ https://www.ncbi.nlm.nih.gov/pubmed/26258673 http://dx.doi.org/10.1097/MBC.0000000000000371 |
work_keys_str_mv | AT freyburgergenevieve rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects AT macouillardgerard rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects AT khennoufakarim rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects AT labrouchesylvie rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects AT molimardmathieu rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects AT sztarkfrancois rivaroxabanandapixabaninorthopaedicsisthereadifferenceintheirplasmaconcentrationsandanticoagulanteffects |