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DOI: 10.1055/s-0043-1775982
Factor Xa Inhibitor Plasma Concentrations and Clinical Outcomes in Patients Weighing ≤50 kg—Experience from Four UK Centers
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Background
In recent years, factor Xa inhibitor (FXaI) research at the extremes of bodyweight has focused on obesity (>120 kg), but significant gaps in clinical outcome data and pharmacokinetic studies exist in those weighing ≤50 kg.[1] [2] In low bodyweight (LBW), the concern is of over-exposure and an increased risk of bleeding. Clinicians are increasingly challenged with this vulnerable population, due to a growing older adult population and with FXaIs more frequently prescribed in patients with cancer. We set out to describe experience from four UK centers on the use of FXaIs in LBW patients (≤50 kg) including a summary of patient characteristics, FXaI plasma concentrations, and clinical outcomes during the first 90 days of treatment.
Authors' Contribution
J.P.P. designed the study, undertook data collection, and wrote the manuscript. V.S. undertook data collection, statistical analysis, and wrote the manuscript. R.B., J.B.-A., R.C., F.A., V.C., R.P., and K.S. undertook data collection, and reviewed the manuscript. R.A. reviewed the manuscript.
Publication History
Received: 31 March 2023
Accepted: 13 September 2023
Article published online:
16 October 2023
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References
- 1 Martin K, Beyer-Westendorf J, Davidson BL, Huisman MV, Sandset PM, Moll S. Use of the direct oral anticoagulants in obese patients: guidance from the SSC of the ISTH. J Thromb Haemost 2016; 14 (06) 1308-1313
- 2 Martin KA, Beyer-Westendorf J, Davidson BL, Huisman MV, Sandset PM, Moll S. Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation. J Thromb Haemost 2021; 19 (08) 1874-1882
- 3 Kaatz S, Ahmad D, Spyropoulos AC, Schulman S. Subcommittee on Control of Anticoagulation. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost 2015; 13 (11) 2119-2126
- 4 Gosselin RC, Adcock DM, Bates SM. et al. International Council for Standardization in Haematology (ICSH) recommendations for laboratory measurement of direct oral anticoagulants. Thromb Haemost 2018; 118 (03) 437-450
- 5 Granger CB, Alexander JH, McMurray JJ. et al; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365 (11) 981-992
- 6 Patel MR, Mahaffey KW, Garg J. et al; ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365 (10) 883-891
- 7 Hohnloser SH, Fudim M, Alexander JH. et al. Efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation and extremes in body weight. Circulation 2019; 139 (20) 2292-2300
- 8 Weitz JI, Farjat AE, Ageno W. et al; GARFIELD-VTE Investigators. Influence of body mass index on clinical outcomes in venous thromboembolism: insights from GARFIELD-VTE. J Thromb Haemost 2021; 19 (12) 3031-3043
- 9 Lee S-R, Choi EK, Park CS. et al. Direct oral anticoagulants in patients with nonvalvular atrial fibrillation and low body weight. J Am Coll Cardiol 2019; 73 (08) 919-931