ArticleTransfusion2026
Red cell exchange removes apixaban in patients with sickle cell disease.
Article in Transfusion, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany patients with sickle cell disease undergo red cell exchange (RCE) and are anticoagulated with apixaban for treatment and/or prevention of venous thromboembolism. Prior studies have demonstrated that apixaban can bind to red blood cells (RBCs). However, the effect of RCE on apixaban levels is unknown. We aimed to determine if RCE alters patient plasma apixaban levels.
methodsPlasma apixaban levels in patients were examined before/after RCE. Apixaban in the RCE collection bag and the hematocrit of the collection bag were quantified. The ability of washed RBCs from healthy donors or from patients on apixaban to inhibit FXa activity was determined using a chromogenic Direct Xa Inhibitor kit.
resultsSeven patients underwent 72 RCE. Plasma apixaban levels declined significantly after RCE (mean decline in apixaban level 68.1 ± 20.7%, p < 0.0001). Apixaban was present in the plasma/supernatant of all RCE collection bags tested. The percent decline in patient plasma apixaban levels after RCE was weakly correlated with the hematocrit of the RCE collection bag (r = 0.36, p = ns). Incubation of FXa with RBCs from patients on apixaban resulted in significantly less FXa activity compared to RBCs from healthy donors (mean Xa activity [A405 nm] of healthy RBC 0.79 ± 1.8 vs. apixaban RBC 0.54 ± 0.22, p = 0.005). DISCUSSION: We provide the first description of apixaban removal with RCE. Removal of apixaban is occurring via removal of incidental plasma and of RBC-bound drug and can result in undetectable drug levels in this high-risk population.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.