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• W4386843584 abstract "This study aimed to characterize apixaban pharmacokinetics (PKs) and its variability in a real-world clinical setting of hospitalized patients using a population PK (PopPK) approach. Model-based simulations helped to identify factors that affect apixaban exposure and their clinical significance. A classic stepwise strategy was applied to determine the best PopPK model for describing typical apixaban PKs in hospitalized patients from the OptimAT study (n = 100) and evaluating the associated variability and influencing factors. Apixaban exposure under specific conditions was assessed using the final model. A two-compartment model with first-order absorption and elimination best described the data. The developed PopPK model revealed a major role of renal function and a minor role of P-glycoprotein phenotypic (P-gp) activity in explaining apixaban variability. The final model indicated that a patient with stage 4 chronic kidney disease (creatinine clearance [CLcr] = 15-29 mL/min) would have a 45% higher drug exposure than a patient with normal renal function (CLcr >90 mL/min), with a further 12% increase if the patient was also a poor metabolizer of P-gp. A high interindividual variability in apixaban PKs was observed in a real-life setting, which was partially explained by renal function and by P-gp phenotypic activity. Target apixaban concentrations are reached under standard dosage regimens, but overexposure can rapidly occur in the presence of cumulative factors warranting the development of a predictive tool for tailoring apixaban exposure and its clinical utility in at-risk patients." @default.
• W4386843584 created "2023-09-20" @default.
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• W4386843584 date "2023-09-18" @default.
• W4386843584 modified "2023-10-15" @default.
• W4386843584 title "Population pharmacokinetics of apixaban in a real‐life hospitalized population from the OptimAT study" @default.
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• W4386843584 doi "https://doi.org/10.1002/psp4.13032" @default.
• W4386843584 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37723920" @default.
• W4386843584 hasPublicationYear "2023" @default.
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