{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:43:47Z","timestamp":1785797027392,"version":"3.56.0"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Medicine Research Found, Chiangmai University","award":["110-2563"],"award-info":[{"award-number":["110-2563"]}]},{"name":"Thai Society of Hematology","award":["110-2563"],"award-info":[{"award-number":["110-2563"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background\/Objectives: Rivaroxaban and dabigatran are commonly used for thromboembolic disease management in active cancer patients. However, limited research explores the impact of concurrent chemotherapy on the pharmacodynamics of direct oral anticoagulants (DOAC). The aim of our study was to evaluate the impact of combined chemotherapy with rivaroxaban and dabigatran on the pharmacodynamics in patients with diffuse large B-cell lymphoma (DLBCL).; Methods: This was a prospective, pharmacodynamic study. Eligible subjects were \u226518 years old, diagnosed with DLBCL and initiating R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) immunochemotherapy. The enrolled adults received either rivaroxaban (10 mg once daily) or dabigatran etixalate (110 mg twice daily). Plasma anti-factor Xa (FXa) in participants on rivaroxaban and diluted thrombin time (dTT) in participants on dabigatran were assessed over the dosing interval before and after R-CHOP administration. Pharmacodynamic parameters of rivaroxaban and dabigatran were determined using a non-compartmental analysis.; Results: Twenty-six adults participated, with twelve in the rivaroxaban group and fourteen in the dabigatran group. The mean age was 59 \u00b1 14.4 years. In the rivaroxaban group, the AUEC of FXa inhibition showed no significant change after R-CHOP (mean difference 3.8 ng\u00b7h\/mL, 95% confidence interval (CI) \u2212155.4 to 163.0, p = 0.96). Similarly, in the dabigatran group, the AUEC of dTT remained unchanged post R-CHOP (mean difference 54.41 ng\u00b7h\/mL, 95% CI \u221299.09 to 207.9 ng\/mL, p = 0.46). However, the median time-to-peak dTT was significantly faster with R-CHOP (3 h, [min\u2013max, 1.5\u20138] compared to without it (4 h, [min\u2013max, 3\u20138], p = 0.04); Conclusions: Concurrent R-CHOP chemotherapy did not significantly impact FXa inhibition by rivaroxaban or dTT by dabigatran. The time-to-peak dTT was faster when dabigatran was administered with R-CHOP.<\/jats:p>","DOI":"10.3390\/pharmaceutics16101319","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T08:10:16Z","timestamp":1728634216000},"page":"1319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacodynamics of Rivaroxaban and Dabigatran in Adults with Diffuse Large B-Cell Lymphoma Receiving R-CHOP Immunochemotherapy"],"prefix":"10.3390","volume":"16","author":[{"given":"Teerachat","family":"Punnachet","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8106-0974","authenticated-orcid":false,"given":"Tim R.","family":"Cressey","sequence":"additional","affiliation":[{"name":"AMS-PHPT Research Collaboration, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Porntipa","family":"Apiwatnakorn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lamphun Hospital, Lamphun 51000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atisa","family":"Koonarat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Nakornping Hospital, Chiang Mai 50180, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalita","family":"Norasetthada","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2381-9292","authenticated-orcid":false,"given":"Adisak","family":"Tantiworawit","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-5544","authenticated-orcid":false,"given":"Ekarat","family":"Rattarittamrong","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-4889","authenticated-orcid":false,"given":"Thanawat","family":"Rattanathammethee","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1248-9734","authenticated-orcid":false,"given":"Sasinee","family":"Hantrakool","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pokpong","family":"Piriyakhuntorn","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonthakorn","family":"Hantrakun","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piangrawee","family":"Niprapan","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatree","family":"Chai-Adisaksopha","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1182\/blood-2013-04-460121","article-title":"Epidemiology of Cancer-Associated Venous 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