Key result
The provided text contains only the journal's editorial board information and no study data.
Why the study?
DOAC trials included few patients weighing 120 kg or more, leaving uncertainty about whether high body weight reduces DOAC concentrations.
Do high body weight patients (≥ 120 kg) achieve therapeutic FXa inhibitor concentrations when receiving standard doses of apixaban or rivaroxaban?
Cohort
Do high body weight patients (≥ 120 kg) achieve therapeutic FXa inhibitor concentrations when receiving standard doses of apixaban or rivaroxaban?
Obese or high body weight patients (≥ 120 kg) generally achieve therapeutic FXa inhibitor concentrations with standard doses of apixaban or rivaroxaban.
No data reported; leaves open all questions on thrombosis outcomes in this cohort.
BACKGROUND: Direct oral anticoagulants (DOACs) are prescribed for atrial fibrillation (AF) and venous thromboembolism (VTE) and both occur more frequently in obese patients. Outcomes from DOAC trials included few individuals ≥ 120 kg leading to uncertainty whether high body weight (BW) reduces DOAC concentrations. OBJECTIVES: This article investigates the relationship between factor Xa (FXa) inhibitor concentrations, BW, and renal function, and compares them in high BW patients with unselected populations. METHODS: Consecutive patients in two United Kingdom centers, weighing ≥ 120 kg receiving 5 mg twice daily apixaban or 20 mg once daily rivaroxaban for AF or VTE were prospectively included. Peak or trough concentrations were measured using specific chromogenic assays, expressed in mean or median (5th-95th percentiles). On-therapy range was the interval from the 5th percentile trough concentration to the 95th percentile peak concentration. RESULTS: . DOAC peak and trough concentrations varied from 44 to 727 and 14 to 299 ng/mL, respectively. There was no linear relationship between FXa inhibitor concentrations at peak or trough and BW or BMI, and creatinine clearance. Apixaban troughs in AF and rivaroxaban peaks in VTE were lower than in unselected populations. However, only two trough concentrations were below the expected range, and 109/116 were within the on-therapy range. CONCLUSION: These data indicated that obese or high BW patients generally achieve therapeutic FXa inhibitor concentrations. However, further investigations assessing clinical outcomes are required.
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Martin et al. (2020) conducted a cohort in Obesity and High Body Weight. Direct Oral Anticoagulants was evaluated. The provided text contains only the journal's editorial board information and no study data.
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