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Nathan A Franklin, Ashley H Ali, Richard K Hurley, Hassan R Mir, Michael J Beltran
OBJECTIVE: To evaluate the prehospital use of direct oral anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture. DESIGN: Case control study. SETTING: Two academic Level 1 trauma centers. INTERVENTION: Early (<48 h) surgical fixation of a geriatric proximal femur fracture. PATIENTS: Nineteen patients receiving Pradaxa (dabigatran), Eliquis (apixaban), or Xarelto (rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients...
June 2018: Journal of Orthopaedic Trauma
Maria L Caraballo, Seda Donmez, Kobi Nathan, Fang Zhao
Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility...
July 2017: Hospital Pharmacy
Sergey V Brodsky, Nilesh S Mhaskar, Sampath Thiruveedi, Rajnish Dhingra, Sharon C Reuben, Edward Calomeni, Iouri Ivanov, Anjali Satoskar, Jessica Hemminger, Gyongyi Nadasdy, Lee Hebert, Brad Rovin, Tibor Nadasdy
Anticoagulant-related nephropathy (ARN) was initially described in patients on warfarin (as warfarin-related nephropathy) and recently in those using dabigatran. Herein, we report clinical history and kidney biopsy findings in a patient on apixaban (Eliquis). Initiation of treatment with apixaban resulted in aggravation of preexisting mild acute kidney injury (AKI). A few days after apixaban therapy, the patient became oligoanuric, and kidney biopsy showed severe acute tubular necrosis with numerous occlusive red blood cell casts...
December 2017: Kidney Research and Clinical Practice
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
June 2017: Archives of Orthopaedic and Trauma Surgery
Christopher Giuliano, Thomas Nofar, Stephanie B Edwin
PURPOSE: To increase patient knowledge about apixaban (Eliquis, Bristol-Myers Squibb) using an educational video delivered in an urban inpatient setting. METHODS: This prospective, quasi-experimental study evaluated knowledge gain and retention in patients receiving apixaban after viewing a short educational video. Knowledge was assessed with a questionnaire immediately before, immediately after, and one month following the educational video. RESULTS: After 33 patients watched the video, scores increased by 19...
April 2017: P & T: a Peer-reviewed Journal for Formulary Management
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
Tagore Sunkara, Emmanuel Ofori, Vadim Zarubin, Megan E Caughey, Vinaya Gaduputi, Madhavi Reddy
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period...
2016: Health Services Insights
Ramzia I El-Bagary, Ehab F Elkady, Naira A Farid, Nadia F Youssef
Apixaban and Tirofiban Hydrochloride are low molecular weight anticoagulants. The two drugs exhibit native fluorescence that allow the development of simple and valid spectrofluorimetric methods for the determination of Apixaban at λ ex/λ em=284/450nm and tirofiban HCl at λ ex/λ em=227/300nm in aqueous media. Different experimental parameters affecting fluorescence intensities were carefully studied and optimized. The fluorescence intensity-concentration plots were linear over the ranges of 0.2-6μgml-1 for apixaban and 0...
March 5, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
C F Munson, A J Reid
Novel oral anticoagulants (NOACs) have emerged as a good alternative to warfarin in the prevention of stroke for patients with atrial fibrillation. NOAC use is increasing rapidly; therefore, greater understanding of their use in the perioperative period is important for optimal care. Studies and reviews that reported on the use of NOACs were identified, with particular focus on the perioperative period. PubMed was searched for relevant articles published between January 2000 and August 2015. The inevitable rise in the use of NOACs such as rivaroxaban (Xarelto™), apixaban (Eliquis™), edoxaban (Lixiana™) and dabigatran (Pradaxa™) may present a simplified approach to perioperative anticoagulant management due to fewer drug interactions, rapidity of onset of action and relatively short half-lives...
May 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
(no author information available yet)
Not more effective than warfarin. The lower incidence of bleeding observed among patients selected for these trials must be weighed against the lack of either an antidote or a routine clotting test.
September 2015: Prescrire International
Guyan Liang, J Phillip Bowen
There has been a revolution in the development of effective, small-molecule anticoagulants and antiplatelet agents. Numerous trypsin-like serine proteases have been under active pursuit as therapeutic targets. Important examples include thrombin, factor VIIa, factor Xa, and β-tryptase with indications ranging from thrombosis and inflammation to asthma and chronic obstructive pulmonary disease (COPD). Trypsin-like serine proteases exhibit a highly similar tertiary folding pattern, especially for the region near the substrate binding pocket that includes the conserved catalytic triad consisting of histidine 57, aspartic acid 102, and serine 195...
2016: Current Topics in Medicinal Chemistry
Henry A Spiller, James B Mowry, Alfred Aleguas, Jill R K Griffith, Robert Goetz, Mark L Ryan, Stacey Bangh, Wendy Klein-Schwartz, Scott Schaeffer, Marcel J Casavant
STUDY OBJECTIVE: Rivaroxaban and apixaban are part of a new group of oral anticoagulants targeting factor Xa and approved by the Food and Drug Administration in 2011 and 2012. These oral anticoagulants are administered at fixed daily doses, without the need for laboratory-guided adjustments. There are limited data available on supratherapeutic doses or overdose of the oral Xa inhibitors. This study characterizes the clinical effect in patients exposed to rivaroxaban and apixaban. METHODS: A retrospective study collected data from 8 regional poison centers covering 9 states...
February 2016: Annals of Emergency Medicine
Antonio Gómez-Outes, Ma Luisa Suárez-Gea, Ramón Lecumberri, Ana Isabel Terleira-Fernández, Emilio Vargas-Castrillón
In recent years, several direct-acting oral anticoagulants (DOAC) have become available for use in Europe and other regions in indications related to prophylaxis and treatment of venous and arterial thromboembolism. They include the oral direct thrombin inhibitor dabigatran etexilate (Pradaxa, Boehringer Ingelheim) and the oral direct FXa inhibitors rivaroxaban (Xarelto, Bayer HealthCare), apixaban (Eliquis, Bristol-Myers Squibb), and edoxaban (Lixiana/Savaysa, Daiichi-Sankyo). The new compounds have a predictable dose response and few drug-drug interactions (unlike vitamin k antagonists), and they do not require parenteral administration (unlike heparins)...
November 2015: European Journal of Haematology
Naiyu Zheng, Long Yuan, Qin C Ji, Heidi Mangus, Yan Song, Charles Frost, Jianing Zeng, Anne-Françoise Aubry, Mark E Arnold
Apixaban (Eliquis™) was developed by Bristol-Myers Squibb (BMS) and Pfizer to use as an antithrombotic/anticoagulant agent and has been recently approved for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. A clinical study of apixaban, sponsored by BMS and Pfizer, included a pilot exploratory portion to evaluate the potential for future drug concentration monitoring using dried blood spot (DBS) sample collection. For DBS sample collection, a fixed blood volume was dispensed onto a DBS card by either regular volumetric pipette (venous blood collection) or capillary dispenser (finger prick blood collection)...
April 15, 2015: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Brandon J McMahon, Hau C Kwaan
One of the major advances in the management of thrombosis is arguably the introduction of the new non-vitamin K antagonist oral anticoagulants (NOACs). These are small molecules, designed to directly inhibit specific steps in the coagulation pathway, with dabigatran (Pradaxa), inhibiting thrombin and rivaroxaban (Xarelto), apixiban (Eliquis), edoxaban (Lixiana), and betrixaban being factor Xa inhibitors. They have several advantages over vitamin K antagonists such as warfarin, with more predictable bioavailability, fewer drug interactions, and improved safety, especially intracranial hemorrhage...
March 2015: Seminars in Thrombosis and Hemostasis
Debora Karetová, Jan Bultas
Thromboembolic disease (TD) is a relatively common disease with acute risk of death and potential long-term consequences in term of postthrombotic syndrome or chronic pulmonary hypertension. Anticoagulant therapy is the basic therapeutic procedure; thrombolytic therapy and the introduction cava filter are appropriately indicated for individual cases. In past few years, new direct oral anticoagulant drugs (NOAC) have occurred - Xa factor or thrombin inhibitors which have demonstrated the same efficacy and even higher safety in comparison to conventional treatment...
November 2014: Vnitr̆ní Lékar̆ství
Janice Pursley, Jim X Shen, Alan Schuster, Oanh T Dang, Jim Lehman, Michael H Buonarati, Yan Song, Anne-Francoise Aubry, Mark E Arnold
BACKGROUND: apixaban (BMS-562247) (Eliquis(®)) is a novel, orally active, selective, direct, reversible inhibitor of the coagulation factor Xa (FXa). A sensitive and reliable method was developed and validated for the measurement of apixaban (BMS-562247) and its major circulating metabolite (BMS-730823) in human citrated plasma for use in clinical testing. METHODOLOGY/RESULTS: A 0.100 ml portion of citrated plasma sample was extracted and analyzed by LC-MS/MS. Run times were approximately 3 min...
August 2014: Bioanalysis
Anna Schlüter, Alf Lamprecht
Anticoagulant therapy is widely used for the treatment and prophylaxis of deep vein thrombosis and coronary syndromes. Until now, drugs such as unfractionated heparin and low molecular weight heparins need to be administered parenterally. Parenteral administration results in lower patient compliance compared to oral therapy and for this reason, the focus of various research groups is to develop an oral heparin formulation which is as effective as the parenteral formulation, easy to use and non-toxic. In the last few years, some new oral anticoagulants like Rivaroxaban (Xarelto(®)), Apixaban (Eliquis(®)) and Dabigatranetexilat (Pradaxa(®)) have reached the market, but their use is limited to certain indications...
2014: Current Pharmaceutical Biotechnology
Claire Curtin, Jamie M Hayes, Jeremy Hayes
UNLABELLED: As dental professionals, we should all be familiar with the most common oral anticoagulant, warfarin, and how to manage our patients that are taking it. However, several new oral anticoagulants which have recently been approved by the National Institute for Health and Care Excellence (NICE) are now being prescribed for patients in the United Kingdom. These new oral anticoagulants fall into two different categories: a direct thrombin inhibitor dabigatran etexilate (Pradaxa Boehringer-Ingelheim, Bracknell, Berkshire) and activated Factor X inhibitors rivaroxaban (Xarelto Bayer HealthCare, Newbury, Berkshire) and apixaban (Eliquis Bristol-Myers Squibb, Uxbridge, Middlesex)...
July 2014: Dental Update
Michael J Orwat, Jennifer X Qiao, Kan He, Alan R Rendina, Joseph M Luettgen, Karen A Rossi, Baomin Xin, Robert M Knabb, Ruth R Wexler, Patrick Y S Lam, Donald J P Pinto
In an effort to identify a potential back-up to apixaban (Eliquis®), we explored a series of diversified P4 moieties. Several analogs with substituted gem-dimethyl moieties replacing the terminal lactam of apixaban were identified which demonstrated potent FXa binding affinity (FXa Ki), good human plasma anticoagulant activity (PT EC2x), cell permeability, and oral bioavailability.
August 1, 2014: Bioorganic & Medicinal Chemistry Letters
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