Why the study?
Whether a lower dose of rivaroxaban is required for Asians remains debatable, prompting an evaluation of potential ethnic differences in pharmacokinetic and pharmacodynamic characteristics between Asians and Caucasians.
Does rivaroxaban have different pharmacokinetic/pharmacodynamic characteristics in Asians compared to Caucasians?
Population
24 studies, including 10 on Asian adults, 11 on predominantly Caucasian adults, and 3 on Caucasian pediatrics
Comparison
Asians vs Caucasians taking rivaroxaban
Design
Systematic review
Key result
The apparent clearance of rivaroxaban was 31-43% higher in Caucasian adults compared to Asian adults, suggesting that a lower dose of rivaroxaban might be required for Asian patients.
Authors
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Ethnic differences in rivaroxaban clearance suggest dosing caution in Asians; leaves open confirmation via dedicated outcome trials.
Systematic Review
Does rivaroxaban have different pharmacokinetic/pharmacodynamic characteristics in Asians compared to Caucasians?
Effect estimate: 31-43% higher in Caucasians
A lower dose of rivaroxaban might be required for Asians due to a 31-43% lower apparent clearance compared to Caucasians.
Liu et al. (2023) conducted a systematic review in Non-valvular atrial fibrillation. Rivaroxaban vs. Caucasians was evaluated on Apparent clearance (CL/F) of rivaroxaban (31-43% higher in Caucasians). The apparent clearance of rivaroxaban was 31-43% higher in Caucasian adults compared to Asian adults, suggesting that a lower dose of rivaroxaban might be required for Asian patients.
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