ArticleJournal of thrombosis and haemostasis : JTH2022
Inter- and intra-individual concentrations of direct oral anticoagulants: The KIDOAC study.
Article in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Population Pharmacokinetic Models for Direct Oral Anticoagulants: A Systematic Review and Clinical Appraisal Using Exposure Simulation.Clinical pharmacology and therapeutics · 2022Pooled it
- Real-World Assessment of Direct Oral Factor Xa Inhibitors: Dosing Appropriateness, Drug Exposure, and Inter-Platform Comparability of Chromogenic Anti-Xa Assays.Diagnostics (Basel, Switzerland) · 2026Article
- The hidden impact of renal impairment on ribociclib exposure and co-medications: a case report.Cancer chemotherapy and pharmacology · 2026Article
- Development of a limited sampling strategy for apixaban area under the curve estimation in elderly patients with non-valvular atrial fibrillation.BMC geriatrics · 2026Article
- Healthcare professionals' perspectives on prescribing DOACs to frail older patients; the DOAC-FRAIL questionnaire.BMC geriatrics · 2026Article
- Perioperative management of colorectal surgical patients receiving a direct oral anticoagulant: a scoping review, particular emphasis on procedure-specific risks, and pharmacogenomics.Frontiers in cardiovascular medicine · 2026Review
- Peak and Trough Concentration Ranges of Factor Xa Inhibitors for Preventing Thromboembolic Stroke in Korean Patients with Non-valvular Atrial Fibrillation.Annals of laboratory medicine · 2026Article
- Rivaroxaban in Chinese children with giant coronary artery aneurysms after Kawasaki disease.Research and practice in thrombosis and haemostasis · 2025Article
- Development of PBPK Population Model for End-Stage Renal Disease Patients to Inform OATP1B-, BCRP-, P-gp-, and CYP3A4-Mediated Drug Disposition with Individual Influencing Factors.Pharmaceutics · 2025Article
- A global survey on practice changes and barriers to the use of direct oral anticoagulants in children.Blood advances · 2025Article
- [Point of care coagulation diagnostics-Absolutely necessary or only a reasonable supplement?]Die Anaesthesiologie · 2025Review
- Microdose Cocktail Study Reveals the Activity and Key Influencing Factors of OATP1B, P-Gp, BCRP, and CYP3A in End-Stage Renal Disease Patients.Clinical pharmacology and therapeutics · 2025Article
- Anti-Platelet factor 4 immunothrombosis-not just heparin and vaccine triggers.Research and practice in thrombosis and haemostasis · 2025Review
- Association of rivaroxaban plasma trough concentrations with clinical characteristics and outcomes.Frontiers in pharmacology · 2025Article
- Pharmacodynamics of Rivaroxaban and Dabigatran in Adults with Diffuse Large B-Cell Lymphoma Receiving R-CHOP Immunochemotherapy.Pharmaceutics · 2024Article
- More early bleeds associated with high baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.Blood advances · 2024Observational
- Proactive monitoring of drug-drug interactions between direct oral anticoagulants and small-molecule inhibitors in patients with non-small cell lung cancer.British journal of cancer · 2024Observational
- Thrombotic events associated with low baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.Blood advances · 2024Observational
- Clot time ratio (CTR) and treatment outcomes in Apixaban-treated atrial fibrillation patients.Scientific reports · 2024Article
- Apixaban plasma concentrations before and after catheter ablation for atrial fibrillation.PloS one · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect oral anticoagulants (DOACs) do not require concentration monitoring. However, whether DOAC concentrations are stable and their variation between and within patients is not well studied.
methodsPatients on vitamin K antagonists (VKA) who switched to rivaroxaban, apixaban, or dabigatran were included between 2018 and 2020. Blood was drawn at DOAC trough and peak concentrations at week 0, 2, and 8. Plasma drug concentrations were determined by anti-factor Xa concentrations (rivaroxaban, apixaban) or diluted thrombin time (dabigatran). Inter- and intra-individual variability was assessed by calculating the coefficient of variation (CV). Linear regression models were employed to evaluate associations between DOAC trough concentrations and previous VKA dosage, creatinine clearance, and body mass index (BMI).
resultsOne hundred fifty-two patients were included, of whom 96 (63%) were male and with a mean age of 73.9 ± 8.4 years. For the inter-individual variability, the CV ranged between 48% and 81% for trough values and between 25% and 69% for peak values among patients using the recommended DOAC dose. Intra-individual variability was substantially lower, as here the CV ranged between 18% and 33% for trough values and between 15% and 29% for peak values among patients using the recommended DOAC dose. Previous VKA dosage and creatinine clearance were inversely associated with DOAC trough concentrations. No association was found between BMI and DOAC trough concentrations.
conclusionInter-individual variability of DOAC concentrations was higher than intra-individual variability. Lower previous VKA dosage and creatinine clearance were associated with higher DOAC trough concentrations. These findings support further study into an optimal target range, in which the risks of both bleeding and thrombosis are minimal.
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