Is a Lower Dose of Rivaroxaban Required for Asians? A Systematic Review of a Population Pharmacokinetics and Pharmacodynamics Analysis of Rivaroxaban

Rivaroxaban has been widely used to prevent and treat various thromboembolic diseases for more than a decade. However, whether a lower dose of rivaroxaban is required for Asians is still debatable. This review aimed to explore the potential ethnic difference in pharmacokinetic/pharmacodynamic (PK/PD...

Full description

Saved in:
Bibliographic Details
Published in:Pharmaceutics 2023-02, Vol.15 (2), p.588
Main Authors: Liu, Xiao-Qin, Li, Zi-Ran, Wang, Chen-Yu, Chen, Yue-Ting, Jiao, Zheng
Format: Article
Language:English
Subjects:
Anticoagulants
Asians
Bioavailability
Clinical trials
Compliance
Demographic aspects
Dosage and administration
Enzymes
ethnic difference
Ethnicity
Evaluation
Health aspects
Oral administration
Pharmacodynamics
Pharmacokinetics
pharmacokinetics/pharmacodynamics
Pharmacology
Population
population pharmacokinetics
Rivaroxaban
Software
Systematic Review
White people
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Rivaroxaban has been widely used to prevent and treat various thromboembolic diseases for more than a decade. However, whether a lower dose of rivaroxaban is required for Asians is still debatable. This review aimed to explore the potential ethnic difference in pharmacokinetic/pharmacodynamic (PK/PD) characteristics between Asians and Caucasians. A systematic search was conducted and twenty-four studies were identified, of which 10 were conducted on Asian adults, 11 on predominantly Caucasian adults, and 3 on Caucasian pediatrics. The apparent clearance (CL/F) of rivaroxaban in Caucasian adults with non-valvular atrial fibrillation (6.45-7.64 L/h) was about 31-43% higher than that in Asians (4.46-5.98 L/h) taking 10~20 mg rivaroxaban every 24 h. Moreover, there was no obvious difference in CL/F among Japanese, Chinese, Thai, and Irani people. Regarding PK/PD relationship, prothrombin time was linked to rivaroxaban concentration in a linear or near-linear manner, and Factor Xa activity was linked with the E model. The exposure-response relationship was comparable between Asians and Caucasians. Renal function has a significant influence on CL/F, and no covariate was recognized for exposure-response relationship. In conclusion, a lower dose of rivaroxaban might be required for Asians, and further studies are warranted to verify this ethnic difference to facilitate optimal dosing regimens.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics15020588