{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:12:33Z","timestamp":1787497953046,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate plasma apixaban concentrations and thrombin generation assay (TGA) parameters across different apixaban doses in atrial fibrillation patients who had dose\u2010reduction criteria for apixaban.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This observational study included 374 patients (mean age 75.6\u2009\u00b1\u20097.7 years, 54.8% female) with dose\u2010reduction criteria for apixaban. The patients were divided into 3 groups: (i) on\u2010label standard dose (5 mg twice daily,\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u00a0166); (ii) on\u2010label reduced dose (2.5 mg twice daily,\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u00a055); and (iii) off\u2010label underdose (2.5 mg twice daily,\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u00a0153). Apixaban concentrations determined via the anti\u2010Xa assay and TGA parameters were compared at trough levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The off\u2010label underdose group exhibited significantly lower apixaban trough concentrations than the on\u2010label reduced\u2010dose and standard\u2010dose groups (56.7\u2009\u00b1\u200942.9\n                      <jats:italic>vs<\/jats:italic>\n                      . 83.7\u2009\u00b1\u200970.4\n                      <jats:italic>vs<\/jats:italic>\n                      . 129.9\u2009\u00b1\u2009101.8 ng\/mL, all\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u00a0.001). Less than 70% of all patients fell within the expected range of apixaban concentrations. Proportions exceeding the upper limit of the expected range were significantly lower in the off\u2010label underdose group (1.3%) than in the on\u2010label reduced\u2010dose (9.1%,\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u00a0.005) and standard\u2010dose (12.7%,\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u00a0.001) groups. The TGA parameters showed the on\u2010label standard\u2010dose group displaying the lowest thrombogenic profiles. Lower creatinine clearance was the most significant predictor of higher apixaban concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Off\u2010label underdosed apixaban resulted in lower apixaban concentrations than both on\u2010label standard and reduced\u2010dose regimens. A considerable proportion of the patients exhibited apixaban concentrations outside the expected range, suggesting the potential benefits of plasma concentration monitoring. Further studies are needed to compare dosages directly, investigate the impact of plasma apixaban concentration monitoring and validate the current dose\u2010reduction criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.16211","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T21:25:20Z","timestamp":1723757120000},"page":"3221-3231","source":"Crossref","is-referenced-by-count":6,"title":["Plasma apixaban concentrations and thrombin generation assay parameters in response to dose reduction for atrial fibrillation"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0751-2407","authenticated-orcid":false,"given":"Muhan","family":"Yeo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So\u2010Ryoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-6372","authenticated-orcid":false,"given":"Eue\u2010Keun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JungMin","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung\u2010Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo\u2010Jeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soonil","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul Metropolitan Government Seoul National University Boramae Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyoung\u2010Seob","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Keimyung University Dongsan Medical Centre  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seil","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Internal Medicine Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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