Proteinuria Clinical Trial
Official title:
Pharmacokinetics of Apixaban in Nephrotic Syndrome
This study is to investigate the pharmacokinetics and pharmacodynamics of apixaban in nephrotic syndrome.
Nephrotic syndrome (NS) is characterized by proteinuria and hypoalbuminemia, and patients
with nephrotic syndrome are known to be hypercoaguable with increased incidence of venous
thromboembolism necessitating anticoagulation. While classically warfarin has been used as an
anticoagulant in NS, newer oral anticoagulants, such as apixaban, are increasingly used to
treat venous thromboembolism (VTE) in the general population. It is unknown how
hypoalbuminemia and proteinuria affect the pharmacokinetics and pharmacodynamics of apixaban.
This will be a parallel arm, single-dose pilot study of the pharmacokinetics of apixaban in
adults with nephrotic syndrome. Goal enrollment of twenty subjects with non-diabetic
nephropathy who have nephrotic-range proteinuria, defined as >3.5g/24 hours or UPC >3.5 and
ten healthy control subjects without nephrotic syndrome. Each subject will be administered a
single dose of apixaban 10 mg. Plasma drug concentration level and plasma anti-Xa activity
levels will be measured at 0, 0.5, 1, 3, 4, 6, 8, 24 hours after drug administration in order
to determine the maximum plasma concentration of apixaban, area under the curve, and
half-life of apixaban in the setting of hypoalbuminemia and proteinuria due to nephrotic
syndrome. Apixaban levels will be measured via liquid-chromatography spectrometry mass.
Additionally, thrombin generation will be measured at 0, 3, 6, and 24 hours.
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