Evaluating Anti-factor Xa Levels in Patients with Augmented Renal Clearance Receiving Enoxaparin Prophylaxis: An Exploratory Pilot Study

Objective: Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin’s enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor Xa levels...

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Bibliographic Details
Main Authors: Zahra Sahraei, Azadeh Eshraghi, Saghar Barati
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Research in Pharmacy Practice
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Online Access:https://journals.lww.com/10.4103/jrpp.jrpp_11_25
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Summary:Objective: Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin’s enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor Xa levels in patients with augmented renal clearance (ARC) receiving enoxaparin prophylaxis. Methods: Forty patients aged 18 years or older receiving 40 mg of enoxaparin for deep vein thrombosis prophylaxis with a high ARC score were observed. ARC was confirmed by creatinine clearance exceeding 130 mL/min. Exclusion criteria included various conditions impacting hemostasis. The objective was to assess antifactor Xa levels 4 h after the fourth dose of enoxaparin administration using a chromogenic assay. Findings: The mean ± standard deviation of the antifactor Xa levels was 0.28 ± 0.21. A significant number of participants (65%) had suboptimal antifactor Xa levels. Conclusion: The prophylactic use of enoxaparin in patients with ARC may result in insufficient antifactor Xa levels. Although the mean levels were within the target range, many individuals did not reach the target level. Healthcare providers should consider renal function and ARC when prescribing enoxaparin to prevent thromboembolic events.
ISSN:2319-9644
2279-042X