Hensler David, Burghardt Danielle
Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI, USA.
J Pharm Technol. 2025 Sep 9:87551225251369344. doi: 10.1177/87551225251369344.
Therapeutic plasma exchange (TPE) may enhance the elimination of drugs from human plasma. Removal of apixaban during TPE has not been extensively described previously. This is a retrospective report of a 76-year-old man admitted to the hospital on apixaban with acute worsening of respiratory and bulbar symptoms due to myasthenia gravis. On hospital day (HOD) 1, TPE was initiated for management of myasthenic crisis. Apixaban levels were obtained before and after a TPE session on HOD 3. On HOD 3, the patient's apixaban plasma level decreased from 88 ng/mL before TPE to 81 ng/mL after. Apixaban displayed an elimination half-life of 65.5 hours with intervening TPE. We report no clinically significant apixaban removal in a patient undergoing TPE for myasthenic crisis. This differs from previous reports. Supplemental dosing or rescheduling of apixaban doses around TPE sessions may be unnecessary, though more data are needed.
治疗性血浆置换（TPE）可能会增强药物从人体血浆中的清除。此前，TPE过程中阿哌沙班的清除情况尚未得到广泛描述。这是一份关于一名76岁男性的回顾性报告，该患者因重症肌无力导致呼吸和延髓症状急性加重，服用阿哌沙班入院。在住院第1天（HOD 1），开始进行TPE以治疗重症肌无力危象。在HOD 3进行一次TPE治疗前后检测了阿哌沙班水平。在HOD 3，患者的阿哌沙班血浆水平从TPE前的88 ng/mL降至之后的81 ng/mL。在进行TPE期间，阿哌沙班的消除半衰期为65.5小时。我们报告，在一名因重症肌无力危象接受TPE治疗的患者中，未发现具有临床意义的阿哌沙班清除情况。这与之前的报告不同。虽然需要更多数据，但在TPE治疗期间可能无需补充给药或重新安排阿哌沙班的给药时间。
