Development of a Bayesian estimation tool to determine the optimal duration of apixaban discontinuation before a high-bleeding risk procedure.
Bayesian estimator
apixaban
pharmacokinetic
simulation
Journal
Fundamental & clinical pharmacology
ISSN: 1472-8206
Titre abrégé: Fundam Clin Pharmacol
Pays: England
ID NLM: 8710411
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
revised:
25
01
2022
received:
04
11
2021
accepted:
18
02
2022
pubmed:
23
2
2022
medline:
14
9
2022
entrez:
22
2
2022
Statut:
ppublish
Résumé
Apixaban is a direct oral anticoagulant (DOAC). Many studies have shown that it shows high pharmacokinetic interindividual and intraindividual variability (IIV). The risk of hemorrhage is a major concern for patients treated with apixaban to undergo an operation or an invasive procedure. Due to this large pharmacokinetic variability, the current recommendations concerning the optimal duration of apixaban discontinuation before a high-bleeding risk procedure concern the general population and not a specific patient. The aim of this study was (1) to investigate by simulation the distribution of decay time of apixaban concentration and (2) to develop and validate an easy-to-use web tool to estimate the individual decay time of apixaban in a "real-life" situation. A systematic review of the literature was conducted to select the relevant pharmacokinetic models for the creation of the web tool. For each model, pharmacokinetic profiles were simulated and the time to reach concentrations below the threshold of 30 ng/ml (T30) was calculated. One of the selected models was chosen to perform a Bayesian estimation and predict the optimal duration of apixaban discontinuation before a high-bleeding risk procedure. All these results were concatenated into the PrevBleed application developed with the R Shiny package.
Substances chimiques
Anticoagulants
0
Pyrazoles
0
Pyridones
0
apixaban
3Z9Y7UWC1J
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
898-907Informations de copyright
© 2022 Société Française de Pharmacologie et de Thérapeutique.
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