ArticleThrombosis research2021
Pharmacokinetics of enoxaparin in COVID-19 critically ill patients.
Article in Thrombosis research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 22 citations in OpenAlex.
- A real-world data-driven approach to optimizing enoxaparin dosing in burn patients.British journal of clinical pharmacology · 2026Article
- Revisiting low-molecular-weight heparin for venous thromboembolism: from pharmacology to precision dosing and implementation.Frontiers in pharmacology · 2026Review
- Policy Adherence to Antithrombotic Therapy for Prophylactic Anticoagulation in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.Journal of pediatrics. Clinical practice · 2025Article
- Time in Therapeutic Range of Unfractionated Heparin-Based Therapy in Critically Ill Patients with COVID-19 Pneumonia.Therapeutics and clinical risk management · 2024Article
- Population Pharmacokinetics and Probability of Target Attainment Analysis of Nadroparin in Different Stages of COVID-19.Clinical pharmacokinetics · 2023Article
- Effects of dalteparin on anti-Xa activities cannot be predicted in critically ill COVID-19 patients.British journal of clinical pharmacology · 2022Article
- Review
- Augmented renal clearance in critically ill COVID-19 patients: Forewarned is forearmed.Journal of critical care · 2021Article
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn intensive-care unit (ICU) patients, pathophysiological changes may affect the pharmacokinetics of enoxaparin and result in underdosing.
objectivesTo develop a pharmacokinetic model of enoxaparin to predict the time-exposure profiles of various thromboprophylactic regimens in COVID-19 ICU-patients.
methodsThis was a retrospective study in ICUs of two French hospitals. Anti-Xa activities from consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated with enoxaparin for the prevention or the treatment of venous thrombosis were used to develop a population pharmacokinetic model using non-linear mixed effects techniques. Monte Carlo simulations were then performed to predict enoxaparin exposure at steady-state after three days of administration.
resultsA total of 391 anti-Xa samples were measured in 95 patients. A one-compartment model with first-order kinetics best fitted the data. The covariate analysis showed that enoxaparin clearance (typical value 1.1 L.h-1) was related to renal function estimated by the CKD-EPI formula and volume of distribution (typical value 17.9 L) to actual body weight. Simulation of anti-Xa activities with enoxaparin 40 mg qd indicated that 64% of the patients had peak levels within the range 0.2 to 0.5 IU.mL-1 and 75% had 12-hour levels above 0.1 IU.mL-1. Administration of a total daily dose of at least 60 mg per day improved the probability of target attainment.
conclusionIn ICU COVID-19 patients, exposure to enoxaparin is reduced due to an increase in the volume of distribution and clearance. Consequently, enoxaparin 40 mg qd is suboptimal to attain thromboprophylactic anti-Xa levels.
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