Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry

How to cite: Suwa, M.; Mori, I.; Kino, M.; Matsui, Y.; Yoshinaga, M.; Takahashi, H.; Takagi, M.; Yoshida, A.; Ichikawa, M.; Nakajima, O.; Tanimura, M.; Shimoyama, H.; Saitoh, H.; Sasaki, I.; Suzuki, T.; Uemae, S. Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry. Preprints 2024, 2024071032. https://doi.org/10.20944/preprints202407.1032.v1 Suwa, M.; Mori, I.; Kino, M.; Matsui, Y.; Yoshinaga, M.; Takahashi, H.; Takagi, M.; Yoshida, A.; Ichikawa, M.; Nakajima, O.; Tanimura, M.; Shimoyama, H.; Saitoh, H.; Sasaki, I.; Suzuki, T.; Uemae, S. Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry. Preprints 2024, 2024071032. https://doi.org/10.20944/preprints202407.1032.v1

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MDPI and ACS Style

Suwa, M.; Mori, I.; Kino, M.; Matsui, Y.; Yoshinaga, M.; Takahashi, H.; Takagi, M.; Yoshida, A.; Ichikawa, M.; Nakajima, O.; Tanimura, M.; Shimoyama, H.; Saitoh, H.; Sasaki, I.; Suzuki, T.; Uemae, S. Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry. Preprints 2024, 2024071032. https://doi.org/10.20944/preprints202407.1032.v1

APA Style

Suwa, M., Mori, I., Kino, M., Matsui, Y., Yoshinaga, M., Takahashi, H., Takagi, M., Yoshida, A., Ichikawa, M., Nakajima, O., Tanimura, M., Shimoyama, H., Saitoh, H., Sasaki, I., Suzuki, T., & Uemae, S. (2024). Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry. Preprints. https://doi.org/10.20944/preprints202407.1032.v1

Chicago/Turabian Style

Suwa, M., Takeshi Suzuki and Satoshi Uemae. 2024 "Efficacy and Safety of Rivaroxaban, Apixaban, and Edoxaban for Nonvalvular Atrial Fibrillation based on Blood Coagulation Activity and Drug Plasma Concentration: SETtsu and north-osaka multicenter Direct Oral AntiCoagulant (SET DOAC) Registry" Preprints. https://doi.org/10.20944/preprints202407.1032.v1

Abstract

Background: The safety and effectiveness of factor-Xa (FXa) inhibitors for nonvalvular atrial fibrillation (NVAF) remains inconclusive. We investigated the current dosing of rivaroxaban, apixaban and edoxaban by monitoring drug plasma concentration (PC) and coagulation activity. Methods and Results: This multicenter clinical study monitored the drug PC levels and two coagulation biomarkers (fibrinogen: FIB, and fibrin monomer complex: FMC) at peak and trough timing in 268 outpatients receiving rivaroxaban (n = 72), apixaban (n = 71), and edoxaban (n = 125) for NVAF. Doses were adjusted according to the dose adjustment criteria of each drug. Based on our previous study, each peak drug PC remained below the cut-off level for predicting bleeding events except in eight patients (three on rivaroxaban, two on apixaban and three on edoxaban) in whom bleeding events occurred; among them, two (one each on rivaroxaban and edoxaban) had a peak drug PC below the cut-off level. Drug PCs widely varied from peak to trough, whereas FMC levels remained within the normal range (< 6.1 µg/ml) regardless of PC variation. These finding suggested that the anticoagulant effects of these drugs persisted throughout the day regardless of the drug PC levels, dosage, and frequency of dosing. Regarding the change in peak drug PC levels over time, rivaroxaban tended to accumulate more than edoxaban (p

Keywords

Anticoagulation monitoring; Apixaban; Atrial fibrillation; Edoxaban; On label dosing; Rivaroxaban

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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