Evaluation of Extended-Interval Dabigatran Dosing in Older Patients With Non-Valvular Atrial Fibrillation.

Abstract

OBJECTIVE:

To evaluate the safety and efficacy of extended-interval dabigatran dosing in older Chinese patients with non-valvular atrial fibrillation.

METHODS:

We conducted an observational study on non-valvular atrial fibrillation patients administered dabigatran at different dosing intervals at the Department of Geriatrics, Peking University First Hospital, China. We enrolled 121 consecutive non-valvular atrial fibrillation patients aged ≥60 years on dabigatran therapy (mean age, 79.6 ± 7.4 years); they were administered conventional low-dose dabigatran (110 mg twice daily) or extended-interval dosing with dabigatran (110 mg every 16 h or every 24 h). All patients received follow-up care, and we evaluated the presence of bleeding and thromboembolic events.

RESULTS:

All patients exhibited creatinine clearance greater than 30 mL/min with an average of 56.6 ± 17.3 mL/min. Sixty-two patients received extended-interval dosing with dabigatran at a mean dose of 117.1 ± 18.6 mg daily. Patients on extended-interval dosing were older; they exhibited lower creatinine clearance and bodyweight and higher CHA2DS2-VASc and HAS-BLED scores. The mean follow-up time was 25.8 ± 15.6 months. No significant differences were observed in the trough and peak values of the activated partial thromboplastin time and in thromboembolic or bleeding events between the 2 groups.

CONCLUSION:

Extended-interval dabigatran dosing in older patients with non-valvular atrial fibrillation and lower creatinine clearance can maintain activated partial thromboplastin time trough and peak values comparable to the conventional low dose. Physician-prescribed practices regarding dabigatran dosing intervals do not lead to worse outcomes in the above-mentioned population.

• Authors: Lianfang Ni, Xiahuan Chen, Meilin Liu, Yan Fan, Zhifang Fu, Dan Sun, Zhijie Zhao
• Journal: Journal of cardiovascular pharmacology and therapeutics (J Cardiovasc Pharmacol Ther) Vol. 26 Issue 4 Pg. 359-364 (07 2021) ISSN: 1940-4034 [Electronic] United States
• PMID: 33263436 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antithrombins
• Creatinine
• Dabigatran

Topics

• Aged
• Aged, 80 and over
• Antithrombins (administration & dosage, therapeutic use)
• Atrial Fibrillation (drug therapy)
• China
• Creatinine (blood)
• Dabigatran (administration & dosage, therapeutic use)
• Drug Administration Schedule
• Drug Monitoring
• Female
• Hemorrhage (chemically induced)
• Humans
• Male
• Partial Thromboplastin Time