Back to Search
Start Over
Simvastatin, but Not Atorvastatin, Is Associated with Higher Peak Rivaroxaban Serum Levels and Bleeding: an Asian Cohort Study from Singapore.
- Source :
-
Cardiovascular drugs and therapy [Cardiovasc Drugs Ther] 2023 Oct; Vol. 37 (5), pp. 917-925. Date of Electronic Publication: 2022 May 14. - Publication Year :
- 2023
-
Abstract
- Aims: This study attempts to identify predictors associated with bleeding and stroke and systemic embolism (SSE) in Singaporean Asians taking rivaroxaban and apixaban.<br />Methods: A total of 134 Singaporean patients on either rivaroxaban or apixaban for non-valvular atrial fibrillation were included for this study. Baseline characteristics were recorded at recruitment while bleeding and SSE events were recorded during a 1-year follow-up. Peak and trough drug plasma concentrations were collected based on the dosing interval and pharmacokinetics of the drugs and quantified using high performance liquid chromatography. Characteristics of patients with or without bleeds were compared using relevant statistical tests. Multivariable regression that included covariates with p < 0.1 from an initial univariable regression was performed to analyse predictors that resulted in higher risk of bleeding in patients.<br />Results: Median creatinine clearance (CrCl) was significantly lower in patients on rivaroxaban who experienced bleeds as compared to patients who did not experience bleeds (61.5 vs 70.8 mL/min, p = 0.047), while concomitant simvastatin use was found to be independently associated with a sixfold increased risk of bleeding (adjusted OR = 6.14 (95% CI: 1.18-31.97), p = 0.031) for rivaroxaban after controlling for body mass index, CrCl and having experienced a previous SSE.<br />Conclusion: Our findings suggest that concomitant use of simvastatin with rivaroxaban may be associated with bleeding events in an Asian cohort. Further studies using physiologically based pharmacokinetic modelling are required to investigate the drug-drug interactions between these drugs.<br /> (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Humans
Anticoagulants adverse effects
Cohort Studies
Dabigatran
Singapore epidemiology
Asian People
Drug Therapy, Combination
Atorvastatin
Atrial Fibrillation diagnosis
Atrial Fibrillation drug therapy
Hemorrhage chemically induced
Rivaroxaban adverse effects
Rivaroxaban blood
Stroke diagnosis
Stroke prevention & control
Simvastatin adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7241
- Volume :
- 37
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Cardiovascular drugs and therapy
- Publication Type :
- Academic Journal
- Accession number :
- 35567727
- Full Text :
- https://doi.org/10.1007/s10557-022-07346-8