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This analysis describes an updated two\u2010compartment population pharmacokinetic (PPK) model that characterizes the PK variability of apixaban in pediatric patients with ALL or LL treated with asparaginase using PK data from a phase III study (PREVAPIX). Patient type of ALL or LL was found to be a significant covariate on the apparent central volume of distribution (Vc\/F) and first\u2010order absorption rate (Ka). Pediatric patients (aged 9\u2009months to &lt;\u200918\u2009years) with ALL or LL had a 52.4% lower Ka compared with adults; this was 81.1% lower than other pediatric patients (9\u2009months to &lt;\u200918\u2009years) at risk of VTE. Apixaban Vc\/F was estimated to be 43.1% lower in pediatric patients compared with adult patients. The updated PPK model was used to simulate and confirm apixaban fixed\u2010dose by weight\u2010tiered regimen\u2010achieved target exposures in pediatric patients (aged 28\u2009days to &lt;\u200918\u2009years) with ALL or LL. In addition, a PK\/pharmacodynamic (PD) analysis was performed using a linear regression model to characterize the relationship between anti\u2010FXa activity (AXA) and apixaban concentration in pediatric patients with ALL or LL. The characterization of apixaban PK and PK\/PD in this analysis contributes to evidence that apixaban could be a potential antithrombotic option in pediatric patients.<\/jats:p>","DOI":"10.1002\/cpt.3616","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:44:04Z","timestamp":1745973844000},"page":"355-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Modeling and Simulation to Inform Apixaban Dosing in Pediatrics With Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma Treated With Asparaginase"],"prefix":"10.1002","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-2483","authenticated-orcid":false,"given":"Praneeth","family":"Jarugula","sequence":"first","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0690-5989","authenticated-orcid":false,"given":"Toni","family":"Ajavon\u2010Hartmann","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obinna","family":"Obianom","sequence":"additional","affiliation":[{"name":"Cognigen, Simulations Plus  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3301-0059","authenticated-orcid":false,"given":"Elizabeth","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Cognigen, Simulations Plus  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Crevar","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Marchisin","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton Pike New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Chen","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"He","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton Pike New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley G.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilmarie","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital  Columbus Ohio USA"},{"name":"The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Lew","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton Pike New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9055-0123","authenticated-orcid":false,"given":"Vidya","family":"Perera","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton Pike New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bindu","family":"Murthy","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Lawrenceville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6659-3687","authenticated-orcid":false,"given":"Samira","family":"Merali","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb  Princeton Pike New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2009.11.005"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2016_113"},{"key":"e_1_2_10_3_1","unstructured":"Bristol\u2010Myers Squibb and Pfizer.ELIQUIS\u00ae (apixaban) tablets for oral use [Prescribing information]<https:\/\/packageinserts.bms.com\/pi\/pi_eliquis.pdf> (2021). 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