Safety and pharmacokinetic profile of apixaban in end‐stage renal disease: A real‐world analysis

During the follow-up period, six (40%) patients died, all for reasons considered unrelated to apixaban (calciphylaxis [n = 1], malignancy [n = 1], frailty leading to withdrawal of dialysis [n = 1], diabetic foot infection [n = 1] and ischaemic heart disease [n = 2]). Eight (53%) patients completed 3 months of monitoring, of whom two patients did not receive planned 1-week monitoring due to blood sampling errors. [...]six (40%) patients followed the monitoring schedule and remained on apixaban for the duration of follow-up. Pharmacokinetic profiling in this analysis demonstrates there was no cumulative exposure of apixaban in dialysis patients; however 25% of the measurements fell below the 5th percentile; this may be due to dialysis reducing the area under the curve of apixaban.