Do direct oral anticoagulants achieve adequate peak plasma concentrations in obese patients weighing over 120 kilograms?
While most extremely obese patients (>120 kg) achieve peak DOAC concentrations above median trough levels, a significant minority (21%) have subtherapeutic peak levels, highlighting potential pharmacokinetic concerns in this population.
Most patients in our study had peak plasma concentration higher than the median trough level for each of the three DOACs. However, 21% had a peak plasma concentration that was below the usual on-therapy range of peak concentration for the corresponding DOAC.
Piran et al. (Thu,) studied this question.