ArticleThrombosis and haemostasis2023
Assessment of DOAC in GEriatrics (Adage Study): Rivaroxaban/Apixaban Concentrations and Thrombin Generation Profiles in NVAF Very Elderly Patients.
Article in Thrombosis and haemostasis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02464488 (Study of Interindividual Variability in the Response to New Oral Direct Anticoagulants), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Study of Interindividual Variability in the Response to New Oral Direct Anticoagulants (Dabigatran Etexilate, Rivaroxaban or Apixaban) in Patients 80 Years Old and Over, Using a Population Pharmacokinetics Approach.
Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- When Fixed-Dose Anticoagulation Meets Frailty.Journal of the American Geriatrics Society · 2026Article
- Assessing the efficacy of a single-cycle measurement and adjustment strategy for direct oral anticoagulants in frail older patients: rationale and design of the DOAC-FRAIL randomized controlled trial.Research and practice in thrombosis and haemostasis · 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
- Analysis of risk factors for bleeding after gastric endoscopic submucosal dissection with an emphasis on age and sex differences: A nationwide population-based study.Surgical endoscopy · 2025Article
- Fibrinography and thrombography (thrombodynamics-4D) in atrial fibrillation assessment of direct oral anticoagulants in geriatrics patients aged 80 years and older receiving direct oral anticoagulant therapy.Research and practice in thrombosis and haemostasis · 2025Article
- Long-term clinical outcomes of oral anticoagulation in the older patients with atrial fibrillation aged ≥80 years: a report from the GLORIA-AF registry phase III.Age and ageing · 2025Article
- Anticoagulant therapy in renal insufficiency theme: Anticoagulation in complex situations.Thrombosis research · 2024Review
- Pharmacokinetics and pharmacodynamics of drug‒drug interactions in hospitalized older adults treated with direct oral anticoagulants.Aging clinical and experimental research · 2024Article
- Thrombin Generation Assay in Antiphospholipid Antibodies Positive Subjects as a Personalized Thrombotic Risk Assessment: State of the Art and Perspectives.Current rheumatology reports · 2024Review
- Thrombotic events associated with low baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.Blood advances · 2024Observational
- Direct Oral Anticoagulants in the Very Elderly.Thrombosis and haemostasis · 2023Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough a growing number of very elderly patients with atrial fibrillation (AF), multiple conditions, and polypharmacy receive direct oral anticoagulants (DOACs), few studies specifically investigated both apixaban/rivaroxaban pharmacokinetics and pharmacodynamics in such patients.
aimsTo investigate: (1) DOAC concentration-time profiles; (2) thrombin generation (TG); and (3) clinical outcomes 6 months after inclusion in very elderly AF in-patients receiving rivaroxaban or apixaban.
methodsAdage-NCT02464488 was an academic prospective exploratory multicenter study, enrolling AF in-patients aged ≥80 years, receiving DOAC for at least 4 days. Each patient had one to five blood samples at different time points over 20 days. DOAC concentrations were determined using chromogenic assays. TG was investigated using ST-Genesia (STG-ThromboScreen, STG-DrugScreen).
resultsWe included 215 patients (women 71.1%, mean age: 87 ± 4 years), 104 rivaroxaban and 111 apixaban, and 79.5% receiving reduced-dose regimen. We observed important inter-individual variabilities (coefficient of variation) whatever the regimen, at
conclusionOur study provides original data in very elderly patients receiving DOAC in a real-life setting, showing great inter-individual variability in plasma concentrations and TG parameters. Further research is needed to understand the potential clinical impact of these findings.
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