SciELO - Scientific Electronic Library Online

vol.106 issue10Inappropriate medicine prescribing in older South Africans: A cross-sectional analysis of medicine claims dataComparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • On index processSimilars in Google


SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574


LOUW, S et al. Correlation between rivaroxaban (Xarelto) plasma activity, patient clinical variables and outcomes in a South African centre. SAMJ, S. Afr. med. j. [online]. 2016, vol.106, n.10, pp.1017-1020. ISSN 2078-5135.

BACKGROUND. Low-molecular-weight heparin and vitamin K antagonists such as warfarin are the gold standard for prohylaxis and treatment of venous thromboembolic disease (VTED). Direct oral anticoagulants (DOACs) result in predictable anticoagulation with significantly reduced inter- and intra-patient variability. DOAC absorption is rapid, with a short half-life and relatively few drug interactions. DOACs are effective and safe at fixed doses without activity monitoring. However, specific situations may require assessment of accurate drug activity. Rivaroxaban, a DOAC targeting activated coagulation factor X (FXa), is registered for the prevention and treatment of VTED in South Africa. OBJECTIVES. To establish a prophylactic rivaroxaban activity level range and determine any associations with clinical complications, viz. haemorrhage and/or thrombosis. METHODS. Samples from 115 orthopaedic patients were tested 3 hours after a prophylactic oral dose of 10 mg rivaroxaban with STAGO rivaroxaban anti-FXa reagent on an automated coagulation analyser. Patient demographics and clinical outcomes were documented. RESULTS. The mean rivaroxaban anti-FXa level was 105.7 ng/mL. Two patients developed adverse events on therapy. One patient had minor bleeding (menorrhagia) (drug activity level 288.7 ng/mL) and another a deep-vein thrombosis (drug activity level 34.7 ng/mL). Statistical analysis demonstrated an association between drug activity and advancing age (p=0.008), most apparent among those aged >65 years. CONCLUSIONS. Measuring rivaroxaban activity levels may reduce uncertainty if treatment failure and complications occur. Patients aged >65 years should be closely monitored. A local expected rivaroxaban activity level for patients on rivaroxaban prophylaxis has been established.

        · text in English     · English ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License