ArticleTherapeutic advances in drug safety2018
Dosing challenges with direct oral anticoagulants in the elderly: a retrospective analysis.
Article in Therapeutic advances in drug safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05086991 (AIHEMAF - P "An Innovative Healthcare Model for AF Patients" No-profit Observational Study on the Role of the Community Pharmacist and "The Pharmacy of Services" in the Case Management of Patients Suffering From Atrial Fibrillation and Being Treated With New Generation Oral Anticoagulants), which is not on this map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
AIHEMAF - P "An Innovative Healthcare Model for AF Patients" No-profit Observational Study on the Role of the Community Pharmacist and "The Pharmacy of Services" in the Case Management of Patients Suffering From Atrial Fibrillation and Being Treated With New Generation Oral Anticoagulants
Who cites it
8 citing papers in PubMed.
- Review
- AIHEMAF-P: An Innovative Healthcare Model for Atrial Fibrillation Patients.Pharmacy (Basel, Switzerland) · 2024Article
- Disparities in the real-world prescription pattern of oral anticoagulants for US Medicare beneficiaries: a geospatial analysis.BMJ open · 2024Article
- Characteristics of patients with atrial fibrillation treated with direct oral anticoagulants and new insights into inappropriate dosing: results from the French National Prospective Registry: PAFF.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- The myths behind DOAC measurement: Analyses of prescribing information from different regulatory bodies and a call for harmonization.Journal of thrombosis and haemostasis : JTH · 2022Article
- Comparing the Efficacy and Safety of Apixaban Versus Warfarin in Morbidly Obese Patients.Cureus · 2022Article
- Impact of the Genotype and Phenotype of CYP3A and P-gp on the Apixaban and Rivaroxaban Exposure in a Real-World Setting.Journal of personalized medicine · 2022Article
- Expert Opinion on Implementing Oral Anticoagulation Reversal Protocols in US Hospitals.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect oral anticoagulants (DOACs) provide patients with attractive options for anticoagulation in atrial fibrillation (AF). However, dosing these agents in the elderly can be challenging due to factors such as drug interactions, reduced renal function, and less frequent monitoring. This study addressed this challenge by reviewing the dosing of three commonly used DOACs (i.e. apixaban, dabigatran, and rivaroxaban) in elderly patients managed at a pharmacist-run anticoagulation clinic.
methodsThis was a single-center, retrospective cohort study. A total of 98 cases of DOAC therapy in patients with AF aged 75 years or older receiving care at a large urban healthcare center were identified
resultsUpon therapy initiation apixaban was dosed in accordance with FDA recommendations in 92.9% of patient cases, dabigatran in 91.2% of cases, and rivaroxaban in 86.1% of cases (
conclusionsPrescribing and maintaining FDA-recommended doses of DOAC agents in the elderly is more challenging than initially perceived. Fluctuations in renal function, comorbidities, and concomitant antiplatelet use may necessitate more individualized dosing strategies with these agents.
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