Pharmacokinetics and Pharmacogenetics of Apixaban

Apixaban is oral anticoagulant, it is widely used in prevention of stroke in non-valvular atrial fibrillation and treatment of deep vein thrombosis and pulmonary embolism. Its main mechanism of action is through reversible inhibition of factor Xa. It specifically binds and inhibits both free and bou...

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Main Authors: A. V. Savinova, M. M. Petrova, N. A. Shnayder, E. N. Bochanova, R. F. Nasyrova
Format: Article
Language:English
Published: Столичная издательская компания 2020-11-01
Series:Рациональная фармакотерапия в кардиологии
Subjects:
Online Access:https://www.rpcardio.online/jour/article/view/2316
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author A. V. Savinova
M. M. Petrova
N. A. Shnayder
E. N. Bochanova
R. F. Nasyrova
author_facet A. V. Savinova
M. M. Petrova
N. A. Shnayder
E. N. Bochanova
R. F. Nasyrova
author_sort A. V. Savinova
collection DOAJ
description Apixaban is oral anticoagulant, it is widely used in prevention of stroke in non-valvular atrial fibrillation and treatment of deep vein thrombosis and pulmonary embolism. Its main mechanism of action is through reversible inhibition of factor Xa. It specifically binds and inhibits both free and bound factor Xa which ultimately results in reduction in the levels of thrombin formation. Apixaban is mainly metabolized by CYP3A4 with minor contributions from CYP1A2, CYP2C8, CYP2C9, CYP2C19 and CYP2J2 isoenzymes. Some of the major metabolic pathways of apixaban include o-demethylation, hydroxylation, and sulfation, with o-demethylapixabansulphate being the major metabolite. The aim of this review is analysis of associated researches of single nucleotide variants (SNV) of CYP3A5 and SULT1A1 genes and search for new candidate genes reflecting effectiveness and safety of apixaban. The search for full-text publications in Russian and English languages containing key words “apixaban”, “pharmacokinetics”, “effectiveness”, “safety” was carried out amongst literature of the past twenty years with the use of eLibrary, PubMed, Web of Science, OMIM data bases. Pharmacokinetics and pharmacogenetics of apixaban are considered in this review. The hypothesis about CYP и SULT1A enzymes influence on apixaban metabolism was examined. To date, numerous SNVs of the CYP3A5 and SULT1A1 genes have been identified, but their potential influence on pharmacokinetics apixaban in clinical practice needs to be further studies. The role of SNVs of other genes encoding beta-oxidation enzymes of apixaban (CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2J2) and transporter proteins (ABCB1, ABCG2) in its efficacy and safety are not well understood, and ABCB1 and ABCG2 genes may be potential candidate genes for studies of the drug safety.
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spelling doaj.art-022fac62ebcd412bb8d1813d0f526dc92024-04-01T07:43:40ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532020-11-0116585286010.20996/1819-6446-2020-10-171806Pharmacokinetics and Pharmacogenetics of ApixabanA. V. Savinova0M. M. Petrova1N. A. Shnayder2E. N. Bochanova3R. F. Nasyrova4Bekhterev National Medical Research Center of Psychiatry and NeurologyKrasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky PartizanaBekhterev National Medical Research Center of Psychiatry and Neurology; Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky PartizanaKrasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky PartizanaBekhterev National Medical Research Center of Psychiatry and Neurology; Kazan Federal UniversityApixaban is oral anticoagulant, it is widely used in prevention of stroke in non-valvular atrial fibrillation and treatment of deep vein thrombosis and pulmonary embolism. Its main mechanism of action is through reversible inhibition of factor Xa. It specifically binds and inhibits both free and bound factor Xa which ultimately results in reduction in the levels of thrombin formation. Apixaban is mainly metabolized by CYP3A4 with minor contributions from CYP1A2, CYP2C8, CYP2C9, CYP2C19 and CYP2J2 isoenzymes. Some of the major metabolic pathways of apixaban include o-demethylation, hydroxylation, and sulfation, with o-demethylapixabansulphate being the major metabolite. The aim of this review is analysis of associated researches of single nucleotide variants (SNV) of CYP3A5 and SULT1A1 genes and search for new candidate genes reflecting effectiveness and safety of apixaban. The search for full-text publications in Russian and English languages containing key words “apixaban”, “pharmacokinetics”, “effectiveness”, “safety” was carried out amongst literature of the past twenty years with the use of eLibrary, PubMed, Web of Science, OMIM data bases. Pharmacokinetics and pharmacogenetics of apixaban are considered in this review. The hypothesis about CYP и SULT1A enzymes influence on apixaban metabolism was examined. To date, numerous SNVs of the CYP3A5 and SULT1A1 genes have been identified, but their potential influence on pharmacokinetics apixaban in clinical practice needs to be further studies. The role of SNVs of other genes encoding beta-oxidation enzymes of apixaban (CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2J2) and transporter proteins (ABCB1, ABCG2) in its efficacy and safety are not well understood, and ABCB1 and ABCG2 genes may be potential candidate genes for studies of the drug safety.https://www.rpcardio.online/jour/article/view/2316apixabanpharmacokineticspharmacogeneticseffectivenesssafetycyp3a5sult1a1abcb1abcg2
spellingShingle A. V. Savinova
M. M. Petrova
N. A. Shnayder
E. N. Bochanova
R. F. Nasyrova
Pharmacokinetics and Pharmacogenetics of Apixaban
Рациональная фармакотерапия в кардиологии
apixaban
pharmacokinetics
pharmacogenetics
effectiveness
safety
cyp3a5
sult1a1
abcb1
abcg2
title Pharmacokinetics and Pharmacogenetics of Apixaban
title_full Pharmacokinetics and Pharmacogenetics of Apixaban
title_fullStr Pharmacokinetics and Pharmacogenetics of Apixaban
title_full_unstemmed Pharmacokinetics and Pharmacogenetics of Apixaban
title_short Pharmacokinetics and Pharmacogenetics of Apixaban
title_sort pharmacokinetics and pharmacogenetics of apixaban
topic apixaban
pharmacokinetics
pharmacogenetics
effectiveness
safety
cyp3a5
sult1a1
abcb1
abcg2
url https://www.rpcardio.online/jour/article/view/2316
work_keys_str_mv AT avsavinova pharmacokineticsandpharmacogeneticsofapixaban
AT mmpetrova pharmacokineticsandpharmacogeneticsofapixaban
AT nashnayder pharmacokineticsandpharmacogeneticsofapixaban
AT enbochanova pharmacokineticsandpharmacogeneticsofapixaban
AT rfnasyrova pharmacokineticsandpharmacogeneticsofapixaban