{"id":1764,"date":"2023-11-27T12:11:21","date_gmt":"2023-11-27T09:11:21","guid":{"rendered":"https:\/\/nor-ijournal.com\/?p=1764"},"modified":"2023-12-06T18:35:24","modified_gmt":"2023-12-06T15:35:24","slug":"121-11","status":"publish","type":"post","link":"https:\/\/nor-ijournal.com\/ru\/2023\/11\/27\/121-11\/","title":{"rendered":"Solovev \u041c., Gulyaev N., Kotlovskaya L., Udut V. – POSSIBILITIES FOR RAPID MONITORING OF THE ANTITHROMBOTIC EFFECTIVENESS OF APIXABAN"},"content":{"rendered":"\t\t
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POSSIBILITIES FOR RAPID MONITORING OF THE ANTITHROMBOTIC EFFECTIVENESS OF APIXABAN<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Solovev<\/strong> \u041c<\/strong>.
<\/strong>Federal State Budgetary Institution \u201cNational Medical Research Center for High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky Ministry of Defense of Russia, 143420, Moscow region, Krasnogorsk, Novy village, ter. 3 TsVKG named after. <\/em>A.A. Vishnevskogo, 1<\/em><\/p>

Gulyaev N.
<\/strong>Federal State Budgetary Institution \u201cNational Medical Research Center for High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky Ministry of Defense of Russia, 143420, Moscow region, Krasnogorsk, Novy village, ter. 3 TsVKG named after. <\/em>A.A. Vishnevskogo, 1<\/em><\/p>

Kotlovskaya L.
<\/strong>Federal State Budgetary Institution \u201cNational Medical Research Center for High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky Ministry of Defense of Russia, 143420, Moscow region, Krasnogorsk, Novy village, ter. 3 TsVKG named after. <\/em>A.A. Vishnevskogo, 1<\/em><\/p>

Udut<\/strong> V.
<\/strong>Federal State Budgetary Scientific Institution “Tomsk National Research Medical Center of the Russian Academy of Sciences”, Research Institute of Pharmacology and Regenerative Medicine named after. <\/em>E.D. Goldberg, 634028, Tomsk, Lenin Ave. 3. <\/em><\/p>

Abstract
<\/strong>Data are presented on the nuances of the relationship between the pharmacokinetics of Apixaban and its pharmacodynamics in healthy individuals, where, as a control for the anticoagulant effects of the drug, a global method was used – low-frequency piezothromboelastography (LFPTEG), and the pharmacokinetics were assessed by a validated HPLC-MS\/MS technique. With a single use of Apixaban at a dose of 5 mg, its maximum concentration was determined at the 4th hour after administration (130 [117;144] ng\/ml) with a rapid peak rise from zero to 97 [86;105] ng\/ml in the first hour of observation . After reaching the maximum concentration of the drug, there is a fairly smooth decrease: from 120 [108;130] ng\/ml on the 6th, to 97 [88;107] ng\/ml on the 10th hour of observation, after 84 [75;93] ] ng\/ml at the 12th hour and up to 19 [17;22] ng\/ml at the 24th hour. Initially, all analyzed characteristics of LFPTEG were within the reference values. 2 hours after taking apixaban at its concentration within 110 [99;121] ng\/ml, according to the results of LFPTEG, a tendency towards chronometric and structural hypocoagulation is formed. At the 3rd hour of observation, with an apixaban concentration within 123 [110;135] ng\/ml, a hypocoagulation shift in the hemostatic potential was formed according to a statistically significant increase in the time to reach the \u201cgelation\u201d point and a decrease in the thrombin activity constant in relation to those assessed at baseline (p\u22640.05). The maximum manifestations of hypocoagulation (statistically significant increase in the \u201cgelation\u201d time with a decrease in the maximum amplitude, thrombin activity constant and coagulation drive index p\u22640.05) were detected at the 4th hour of monitoring, where the maximum concentration of the drug was determined. At the 6th hour, LFPTEG revealed moderate structural hypocoagulation, which by the 10th hour of observation, based on the severity of the manifestations, was determined only as a trend. And at the 12th hour there is an increase in thrombin activity and a reduction in the \u201cgelation\u201d time in relation to the initial data. The results obtained allow us to conclude that it is possible to use LFPTEG technology to monitor the pharmacodynamics of Apixaban, which in healthy individuals is possible in the range of working plasma concentrations of the drug from ~110 ng\/ml and above.<\/p>

Keywords:<\/strong> low-frequency piezothromboelastography, hemostatic potential, antithrombotic therapy, personification, apixaban, NOAC.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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