Literature DB >> 24725442

Safety, tolerability, pharmacokinetics, and pharmacodynamics of multiple doses of apixaban in healthy Japanese male subjects.

Naomi Yamahira, Charles Frost, Hiroyuki Fukase, Zhigang Yu, Jessie Wang, Janice Pursley, Frank LaCreta, Masaki Hiraoka.   

Abstract

OBJECTIVE: This was a randomized, placebo-controlled, double-blind, sequential, ascending-dose study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of multiple oral doses of apixaban in healthy Japanese male subjects.
METHODS: The study was conducted using three sequential dose panels: apixaban 2.5 mg, 5 mg, and 10 mg given twice daily. For each dose panel, subjects were randomly assigned to receive oral apixaban (n = 6) or matching placebo (n = 2) for 7 days. The pharmacokinetics of apixaban and effect on pharmacodynamic variables (clotting assays and anti-Xa activity) were assessed on day 1 and day 7 of treatment. Safety was assessed throughout the study. Only after the preceding dose was confirmed to be safe and well-tolerated subjects were enrolled into the next-higher-dose panel.
RESULTS: Apixaban was safe and well-tolerated in these healthy Japanese male subjects across the doses evaluated. On day 7, peak plasma concentrations were reached ~ 3 hours postdose, and increases in peak plasma concentration (C(max)), trough plasma concentration, and area under the plasma concentration-time curve across one dosing interval (12 hours) were tested dose-proportional across the dose range. A modest degree of accumulation was observed that was similar for all doses (accumulation index of 1.7 to 2.0), and renal clearance was consistent across doses (0.91 L/h - 1.07 L/h). Exposure-dependent prolongation of prothrombin time, activated partial thromboplastin time, modified prothrombin time, and increases in anti-Xa activity were observed after single and multiple doses of apixaban.
CONCLUSIONS: Apixaban was safe and well-tolerated in healthy Japanese subjects. The pharmacokinetic profile of apixaban following multiple twice-daily doses was linear, and exposure parameters such as C(max), observed at ~ 3 hours post-dose, and area under the plasma concentration-time curve increased in a dose-proportional manner. Pharmacodynamic profiles closely followed the apixaban plasma concentration-time profiles.

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Year:  2014        PMID: 24725442     DOI: 10.5414/CP201967

Source DB:  PubMed          Journal:  Int J Clin Pharmacol Ther        ISSN: 0946-1965            Impact factor:   1.366


  15 in total

1.  Population Pharmacokinetics and Pharmacodynamics of Apixaban Linking Its Plasma Concentration to Intrinsic Activated Coagulation Factor X Activity in Japanese Patients with Atrial Fibrillation.

Authors:  Satoshi Ueshima; Daiki Hira; Chiho Tomitsuka; Miki Nomura; Yuuma Kimura; Takuya Yamane; Yohei Tabuchi; Tomoya Ozawa; Hideki Itoh; Minoru Horie; Tomohiro Terada; Toshiya Katsura
Journal:  AAPS J       Date:  2019-06-24       Impact factor: 4.009

2.  Apixaban Pharmacokinetics at Steady State in Hemodialysis Patients.

Authors:  Thomas A Mavrakanas; Caroline F Samer; Sharon J Nessim; Gershon Frisch; Mark L Lipman
Journal:  J Am Soc Nephrol       Date:  2017-03-16       Impact factor: 10.121

Review 3.  Apixaban: A Review in Venous Thromboembolism.

Authors:  Sarah L Greig; Karly P Garnock-Jones
Journal:  Drugs       Date:  2016-10       Impact factor: 9.546

4.  Population pharmacokinetics and pharmacogenomics of apixaban in Japanese adult patients with atrial fibrillation.

Authors:  Satoshi Ueshima; Daiki Hira; Yuuma Kimura; Ryo Fujii; Chiho Tomitsuka; Takuya Yamane; Yohei Tabuchi; Tomoya Ozawa; Hideki Itoh; Seiko Ohno; Minoru Horie; Tomohiro Terada; Toshiya Katsura
Journal:  Br J Clin Pharmacol       Date:  2018-04-16       Impact factor: 4.335

5.  Evaluation of the effect of apixaban using a viscoelastic coagulation assay with Russell's viper venom reagent.

Authors:  Kaoru Suzuki; Nobuyuki Katori; Yoshihiro Kimura; Takako Terui; Hiroshi Sunaga; Shunsuke Kobayashi; Shoichi Uezono
Journal:  JA Clin Rep       Date:  2021-05-06

6.  A randomized direct comparison of the pharmacokinetics and pharmacodynamics of apixaban and rivaroxaban.

Authors:  Charles Frost; Yan Song; Yu Chen Barrett; Jessie Wang; Janice Pursley; Rebecca A Boyd; Frank LaCreta
Journal:  Clin Pharmacol       Date:  2014-11-13

7.  Population Pharmacokinetics, Pharmacodynamics, and Exploratory Exposure-Response Analyses of Apixaban in Subjects Treated for Venous Thromboembolism.

Authors:  W Byon; K Sweeney; C Frost; R A Boyd
Journal:  CPT Pharmacometrics Syst Pharmacol       Date:  2017-05

8.  Rivaroxaban and apixaban in orthopaedics: is there a difference in their plasma concentrations and anticoagulant effects?

Authors:  Geneviève Freyburger; Gérard Macouillard; Karim Khennoufa; Sylvie Labrouche; Mathieu Molimard; François Sztark
Journal:  Blood Coagul Fibrinolysis       Date:  2015-12       Impact factor: 1.276

Review 9.  Safety of apixaban for venous thromboembolism prophylaxis: the evidence to date.

Authors:  Vladimir Trkulja
Journal:  Drug Healthc Patient Saf       Date:  2016-02-18

10.  Four-factor prothrombin complex concentrate reverses apixaban-associated bleeding in a rabbit model of acute hemorrhage.

Authors:  E Herzog; F Kaspereit; W Krege; J Mueller-Cohrs; B Doerr; P Niebl; G Dickneite
Journal:  J Thromb Haemost       Date:  2015-11-24       Impact factor: 5.824

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