Apixaban: Difference between revisions
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'''Apixaban''' is an oral [[anticoagulant]]. Apixaban is an oral inhibitor of clotting Factor Xa inhibitor. | '''Apixaban''' is an oral [[anticoagulant]]. Apixaban is an oral inhibitor of clotting Factor Xa inhibitor. | ||
==Metabolism== | ==History== | ||
As of 8/2011, apixiban is not approved for use in the [[United States of America]]. | |||
==Pharmacology== | |||
===Administration=== | |||
===Distribution=== | |||
===Metabolism=== | |||
Hepatic metabolism. | Hepatic metabolism. | ||
===Excretion=== | |||
===Toxicity=== | |||
==Clinical use== | ==Clinical use== | ||
Apixaban can prevent can prevent [[embolism and thrombosis]] during [[perioperative care]] according to [[randomized controlled trial]]s of knee<ref name="pmid19657123">{{cite journal| author=Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ| title=Apixaban or enoxaparin for thromboprophylaxis after knee replacement. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 6 | pages= 594-604 | pmid=19657123 | doi=10.1056/NEJMoa0810773 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19657123 }} </ref> and hip<ref name="pmid21175312">{{cite journal| author=Lassen MR, Gallus A, Raskob GE, Pineo G, Chen D, Ramirez LM et al.| title=Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 26 | pages= 2487-98 | pmid=21175312 | doi=10.1056/NEJMoa1006885 | pmc= | url= }} </ref> surgery. | Apixaban can prevent can prevent [[embolism and thrombosis]] during [[perioperative care]] according to [[randomized controlled trial]]s of knee<ref name="pmid19657123">{{cite journal| author=Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ| title=Apixaban or enoxaparin for thromboprophylaxis after knee replacement. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 6 | pages= 594-604 | pmid=19657123 | doi=10.1056/NEJMoa0810773 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19657123 }} </ref> and hip<ref name="pmid21175312">{{cite journal| author=Lassen MR, Gallus A, Raskob GE, Pineo G, Chen D, Ramirez LM et al.| title=Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. | journal=N Engl J Med | year= 2010 | volume= 363 | issue= 26 | pages= 2487-98 | pmid=21175312 | doi=10.1056/NEJMoa1006885 | pmc= | url= }} </ref> surgery. | ||
Apixaban may also reduce embolism better than warfarin in [[atrial fibrillation]].<ref name="doi10.1056/NEJMoa1107039">{{Cite journal | Apixaban may also reduce embolism better than warfarin in [[atrial fibrillation]].<ref name="doi10.1056/NEJMoa1107039">{{Cite journal | doi = 10.1056/NEJMoa1107039 | issn = 0028-4793 | pages = 110827230022006 | last = Granger | first = Christopher B. | coauthors = John H. Alexander, John J.V. McMurray, Renato D. Lopes, Elaine M. Hylek, Michael Hanna, Hussein R. Al-Khalidi, Jack Ansell, Dan Atar, Alvaro Avezum, M. Cecilia Bahit, Rafael Diaz, J. Donald Easton, Justin A. Ezekowitz, Greg Flaker, David Garcia, Margarida Geraldes, Bernard J. Gersh, Sergey Golitsyn, Shinya Goto, Antonio G. Hermosillo, Stefan H. Hohnloser, John Horowitz, Puneet Mohan, Petr Jansky, Basil S. Lewis, Jose Luis Lopez-Sendon, Prem Pais, Alexander Parkhomenko, Freek W.A. Verheugt, Jun Zhu, Lars Wallentin | title = Apixaban versus Warfarin in Patients with Atrial Fibrillation | journal = New England Journal of Medicine | accessdate = 2011-08-28 | date = 2011-08 | url = http://www.nejm.org/doi/abs/10.1056/NEJMoa1107039 }}</ref> <ref name="pmid21309657">{{cite journal| author=Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S et al.| title=Apixaban in patients with atrial fibrillation. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 9 | pages= 806-17 | pmid=21309657 | doi=10.1056/NEJMoa1007432 | pmc= | url= }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21502641 Review in: Ann Intern Med. 2011 Apr 19;154(8):JC4-3] </ref> | ||
| doi = 10.1056/NEJMoa1107039 | issn = 0028-4793 | pages = 110827230022006 | last = Granger | first = Christopher B. | coauthors = John H. Alexander, John J.V. McMurray, Renato D. Lopes, Elaine M. Hylek, Michael Hanna, Hussein R. Al-Khalidi, Jack Ansell, Dan Atar, Alvaro Avezum, M. Cecilia Bahit, Rafael Diaz, J. Donald Easton, Justin A. Ezekowitz, Greg Flaker, David Garcia, Margarida Geraldes, Bernard J. Gersh, Sergey Golitsyn, Shinya Goto, Antonio G. Hermosillo, Stefan H. Hohnloser, John Horowitz, Puneet Mohan, Petr Jansky, Basil S. Lewis, Jose Luis Lopez-Sendon, Prem Pais, Alexander Parkhomenko, Freek W.A. Verheugt, Jun Zhu, Lars Wallentin | title = Apixaban versus Warfarin in Patients with Atrial Fibrillation | journal = New England Journal of Medicine | accessdate = 2011-08-28 | |||
| date = 2011-08 | url = http://www.nejm.org/doi/abs/10.1056/NEJMoa1107039 }}</ref> | |||
<ref name="pmid21309657">{{cite journal| author=Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S et al.| title=Apixaban in patients with atrial fibrillation. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 9 | pages= 806-17 | pmid=21309657 | doi=10.1056/NEJMoa1007432 | pmc= | url= }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21502641 Review in: Ann Intern Med. 2011 Apr 19;154(8):JC4-3] </ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ [[Randomized controlled trial]]s of apixaban for [[atrial fibrillation]] | |+ [[Randomized controlled trial]]s of apixaban for [[atrial fibrillation]].<ref name="doi10.1056/NEJMoa1107039" /><ref name="pmid21309657">{{cite journal| author=Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S et al.| title=Apixaban in patients with atrial fibrillation. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 9 | pages= 806-17 | pmid=21309657 | doi=10.1056/NEJMoa1007432 | pmc= | url= }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21502641 Review in: Ann Intern Med. 2011 Apr 19;154(8):JC4-3] </ref> | ||
! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results | ! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results | ||
|-<br/> | |-<br/> | ||
| Line 21: | Line 25: | ||
| AVERROES<ref name="pmid21309657"/><br/>2011|| 5599 patients<br/>• All had contraindications to [[warfarin]] || apixaban 5 mg twice daily||[[aspirin]] 81 to 324 mg per day|| [[stroke]] or systemic embolism at 1.1 years|| 1.6% per year|| 3.7% per year | | AVERROES<ref name="pmid21309657"/><br/>2011|| 5599 patients<br/>• All had contraindications to [[warfarin]] || apixaban 5 mg twice daily||[[aspirin]] 81 to 324 mg per day|| [[stroke]] or systemic embolism at 1.1 years|| 1.6% per year|| 3.7% per year | ||
|- | |- | ||
| ARISTOTLE<ref name="doi10.1056/NEJMoa1107039"/><br/>2011|| 18,201 patients|| apixaban 5 mg twice daily ||[[warfarin]] (target [[International Normalized Ratio|INR]] 2.0 to 3.0|| [[stroke]] or systemic embolism at 1.3 years||1. | | ARISTOTLE<ref name="doi10.1056/NEJMoa1107039"/><br/>2011|| 18,201 patients|| apixaban 5 mg twice daily ||[[warfarin]] (target [[International Normalized Ratio|INR]] 2.0 to 3.0|| [[stroke]] or systemic embolism at 1.3 years||1.3% per year|| 1.6% per year | ||
|} | |} | ||
Latest revision as of 13:47, 31 May 2024
Apixaban is an oral anticoagulant. Apixaban is an oral inhibitor of clotting Factor Xa inhibitor.
History
As of 8/2011, apixiban is not approved for use in the United States of America.
Pharmacology
Administration
Distribution
Metabolism
Hepatic metabolism.
Excretion
Toxicity
Clinical use
Apixaban can prevent can prevent embolism and thrombosis during perioperative care according to randomized controlled trials of knee[1] and hip[2] surgery.
Apixaban may also reduce embolism better than warfarin in atrial fibrillation.[3] [4]
| Trial | Patients | Intervention | Comparison | Outcome | Results | |
|---|---|---|---|---|---|---|
| Intervention | Control | |||||
| AVERROES[4] 2011 |
5599 patients • All had contraindications to warfarin |
apixaban 5 mg twice daily | aspirin 81 to 324 mg per day | stroke or systemic embolism at 1.1 years | 1.6% per year | 3.7% per year |
| ARISTOTLE[3] 2011 |
18,201 patients | apixaban 5 mg twice daily | warfarin (target INR 2.0 to 3.0 | stroke or systemic embolism at 1.3 years | 1.3% per year | 1.6% per year |
External links
The most up-to-date information about Apixaban and other drugs can be found at the following sites.
- Apixaban - FDA approved drug information (drug label) from DailyMed (U.S. National Library of Medicine).
- Apixaban - Drug information for consumers from MedlinePlus (U.S. National Library of Medicine).
- Apixaban - Detailed information from DrugBank.
References
- ↑ Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ (2009). "Apixaban or enoxaparin for thromboprophylaxis after knee replacement.". N Engl J Med 361 (6): 594-604. DOI:10.1056/NEJMoa0810773. PMID 19657123. Research Blogging.
- ↑ Lassen MR, Gallus A, Raskob GE, Pineo G, Chen D, Ramirez LM et al. (2010). "Apixaban versus enoxaparin for thromboprophylaxis after hip replacement.". N Engl J Med 363 (26): 2487-98. DOI:10.1056/NEJMoa1006885. PMID 21175312. Research Blogging.
- ↑ 3.0 3.1 3.2 Granger, Christopher B.; John H. Alexander, John J.V. McMurray, Renato D. Lopes, Elaine M. Hylek, Michael Hanna, Hussein R. Al-Khalidi, Jack Ansell, Dan Atar, Alvaro Avezum, M. Cecilia Bahit, Rafael Diaz, J. Donald Easton, Justin A. Ezekowitz, Greg Flaker, David Garcia, Margarida Geraldes, Bernard J. Gersh, Sergey Golitsyn, Shinya Goto, Antonio G. Hermosillo, Stefan H. Hohnloser, John Horowitz, Puneet Mohan, Petr Jansky, Basil S. Lewis, Jose Luis Lopez-Sendon, Prem Pais, Alexander Parkhomenko, Freek W.A. Verheugt, Jun Zhu, Lars Wallentin (2011-08). "Apixaban versus Warfarin in Patients with Atrial Fibrillation". New England Journal of Medicine: 110827230022006. DOI:10.1056/NEJMoa1107039. ISSN 0028-4793. Retrieved on 2011-08-28. Research Blogging.
- ↑ 4.0 4.1 4.2 Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S et al. (2011). "Apixaban in patients with atrial fibrillation.". N Engl J Med 364 (9): 806-17. DOI:10.1056/NEJMoa1007432. PMID 21309657. Research Blogging. Review in: Ann Intern Med. 2011 Apr 19;154(8):JC4-3