Bristol Myers Squibb, Princeton, NJ, USA.
Pfizer, Groton, CT, USA.
Clin Pharmacol Drug Dev. 2024 Sep;13(9):961-973. doi: 10.1002/cpdd.1446. Epub 2024 Jul 24.
With many available data sources, clinicians need to consider the benefit-risk profile of individual anticoagulants when balancing the need for anticoagulation, including evaluating the risks in patients with comorbidities and potential drug-drug interactions. This narrative review presents clinical data across multiple phases of drug development for the use of apixaban, a selective factor Xa inhibitor, when taken concomitantly with other agents, and evaluates the benefit-risk profile of apixaban with these interacting medications. Key subgroup analyses from the phase 3 ARISTOTLE trial (NCT00412984) are presented using data from patients who received either concomitant inhibitors or inducers of cytochrome P450 3A4 and/or P‑glycoprotein. We also review the available evidence for the use of apixaban in patients with cancer-associated thromboembolism, as well as the use of apixaban in patients with COVID-19.
有许多可用的数据源,临床医生在平衡抗凝需求时需要考虑个体抗凝剂的获益-风险特征,包括评估合并症患者的风险和潜在的药物相互作用。本综述介绍了在药物开发的多个阶段中使用新型口服抗凝药(NOAC)——直接因子 Xa 抑制剂阿哌沙班的临床数据,评估了阿哌沙班与这些相互作用药物的获益-风险特征。使用来自接受 CYP3A4 和/或 P-糖蛋白同时抑制剂或诱导剂的患者的 ARISTOTLE 试验(NCT00412984)的关键亚组分析数据。我们还回顾了阿哌沙班在癌症相关血栓栓塞患者中的应用,以及阿哌沙班在 COVID-19 患者中的应用。