Major bleeding events in octagenarians associated with drug interactions between dabigatran and P-gp inhibitors
Marjorie Bernier1
Sarah-Line Lancrerot1
Fanny Rocher1
Elise K Van-Obberghen1
Pierre Olivier2
Thibaud Lavrutl1
Nadège Parassol-Girard1
Milou-Daniel Drici1
1.Department of Pharmacology and Toxicology,Pharmaco Vigilance Center,University of Nice C(o)te d'Azur Medical Center,H(o)pital de Cimiez,4 Avenue Reine Victoria,BP 1179,06003,Nice,France2.Emergency Department Short Stay Unit,University of Nice C(o)te d 'Azur Medical Center,H(o)pital Pasteur 2,30,Voie Romaine 06001,Nice,France
摘要：Background The direct oral anticoagulant dabigatran does not require any routine therapeutic drug monitoring.Yet,concerns about possible drug interactions susceptible to increase its inherent bleeding risk,especially in very elderly patients,have been raised recently.The aim of our study was to evaluate to what extent the co-prescription of P-gp inhibitors with dabigatran may increase its plasma levels and lead to bleeding complications,in usual conditions of care of the very elderly.Methods Fifty-eight patients over 85 years old with non valvular atrial fibrillation receiving dabigatran were included in a prospective cohort.Prescriptions were screened for the presence of P-gp inhibitors(Group A)or not(Group B).Results Patients from Group A had increased dabigatran mean plasma concentrations as compared with patients from Group B(A vs.B: 182.2 ± 147.3 vs.93.7 ± 64.9 ng/mL).One third of the patients from Group A had dabigatran concentrations that were deemed "out of range" versus none in Group B(P = 0.05).This was associated with more frequent bleeding complications in Group A(A: 30.4％,B: 8.6％,P = 0.04).Conclusion In our cohort of very elderly patients,at least,the co-prescription of dabigatran with R-gp inhibitors in usual conditions of care resulted in higher dabigatran plasma concentrations and more frequent bleeding occurrences.
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论文发表日期：2019-11-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 806-811 )
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