Literature DB >> 32978221

Dabigatran trough concentrations in very elderly patients.

Ellis Gommans1,2, René J E Grouls3, Daan Kerkhof4, Saskia Houterman5, Tim Simmers6, Carolien Van der Linden7.   

Abstract

OBJECTIVES: The aim of this observational study was to explore dabigatran concentrations in elderly and very elderly patients in a real-life population. Patients aged >75 years receiving dabigatran have a significantly higher risk of gastrointestinal bleeding compared withthose receiving warfarin. High trough concentrations have an important impact on this bleeding risk.
METHODS: We measured dabigatran trough concentrations in 75 patients with atrial fibrillation, divided into age categories <75, ≥75 to 84 and ≥85 years. The most important exclusion criteria were use of interacting medication and severe renal failure. We analysed absolute trough concentrations and concentrations normalised for dose.
RESULTS: Trough concentrations were considerably higher in the highest age category. Dose-normalised medians were 0.66, 0.83 and 1.20 ng/mL/mg in the <75, ≥75-84 and ≥85 age groups, respectively (p=0.004).
CONCLUSION: Clinicians should be aware of higher dabigatran concentrations in elderly patients despite dose reduction. © European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Entities:  

Keywords:  anticoagulants; drug monitoring; geriatrics; safety; thromboembolism

Mesh：

Substances：

Year:  2020        PMID： 32978221      PMCID： PMC8239269          DOI： 10.1136/ejhpharm-2020-002456

Source DB:  PubMed          Journal:  Eur J Hosp Pharm        ISSN： 2047-9956


  8 in total

1.  Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences.

Authors:  Tomáš Bolek; Matej Samoš; Ingrid Škorňová; Lucia Stančiaková; Ján Staško; Peter Galajda; Peter Kubisz; Marián Mokáň
Journal:  Drugs Aging       Date:  2018-06       Impact factor: 3.923

2.  Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial.

Authors:  John W Eikelboom; Lars Wallentin; Stuart J Connolly; Mike Ezekowitz; Jeff S Healey; Jonas Oldgren; Sean Yang; Marco Alings; Scott Kaatz; Stefan H Hohnloser; Hans-Christoph Diener; Maria Grazia Franzosi; Kurt Huber; Paul Reilly; Jeanne Varrone; Salim Yusuf
Journal:  Circulation       Date:  2011-05-16       Impact factor: 29.690

3.  Real-world variability in dabigatran levels in patients with atrial fibrillation.

Authors:  N C Chan; M Coppens; J Hirsh; J S Ginsberg; J I Weitz; T Vanassche; J D Douketis; S Schulman; J W Eikelboom
Journal:  J Thromb Haemost       Date:  2015-01-28       Impact factor: 5.824

4.  The effect of dabigatran plasma concentrations and patient characteristics on the frequency of ischemic stroke and major bleeding in atrial fibrillation patients: the RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy).

Authors:  Paul A Reilly; Thorsten Lehr; Sebastian Haertter; Stuart J Connolly; Salim Yusuf; John W Eikelboom; Michael D Ezekowitz; Gerhard Nehmiz; Susan Wang; Lars Wallentin
Journal:  J Am Coll Cardiol       Date:  2013-09-27       Impact factor: 24.094

5.  Real life dabigatran and metabolite concentrations, focused on inter-patient variability and assay differences in patients with atrial fibrillation.

Authors:  Kristel Boonen; Ellen Schmitz; Fleur Rozestraten; Dennis van den Heuvel; Luc Brunsveld; Pepijn van der Voort; Daan van de Kerkhof
Journal:  Clin Chem Lab Med       Date:  2017-10-26       Impact factor: 3.694

6.  Dabigatran Concentration: Variability and Potential Bleeding Prediction In "Real-Life" Patients With Atrial Fibrillation.

Authors:  Petra Šinigoj; Rickard E Malmström; Nina Vene; Yuko Rönquist-Nii; Mojca Božič-Mijovski; Anton Pohanka; Jovan P Antovic; Alenka Mavri
Journal:  Basic Clin Pharmacol Toxicol       Date:  2015-06-11       Impact factor: 4.080

7.  Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study.

Authors:  Jan Heeringa; Deirdre A M van der Kuip; Albert Hofman; Jan A Kors; Gerard van Herpen; Bruno H Ch Stricker; Theo Stijnen; Gregory Y H Lip; Jacqueline C M Witteman
Journal:  Eur Heart J       Date:  2006-03-09       Impact factor: 29.983

Review 8.  Efficacy and Harms of Direct Oral Anticoagulants in the Elderly for Stroke Prevention in Atrial Fibrillation and Secondary Prevention of Venous Thromboembolism: Systematic Review and Meta-Analysis.

Authors:  Manuj Sharma; Victoria R Cornelius; Jignesh P Patel; J Graham Davies; Mariam Molokhia
Journal:  Circulation       Date:  2015-05-20       Impact factor: 29.690
  8 in total

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