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Theoretical analysis of efficacy and side effects of direct oral anticoagulants for appropriate anticoagulation therapy

Research Project

Project/Area Number 21K06716
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 47060:Clinical pharmacy-related
Research InstitutionTokyo University of Pharmacy and Life Science

Principal Investigator

Yasuhiko Yamada  東京薬科大学, 薬学部, 教授 (40158225)

Co-Investigator(Kenkyū-buntansha) 片桐 文彦  東京薬科大学, 薬学部, 講師 (60420642)
Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2023: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords直接経口抗凝固薬 / 血中濃度 / 比色法 / 第Xa因子 / 抗凝固療法
Outline of Research at the Start

添付文書やインタビューフォーム、原著論文など既存の資料から、薬物動態学的パラメータ、薬力学的パラメータ、ワルファリンと比較した有効性、副作用発現率などを収集・解析し、標的分子結合占有理論を用いて、目標となる血中薬物濃度域を推定する。また、視覚的に評価可能な比色法を用いた薬物濃度測定法を開発する。

Outline of Final Research Achievements

With the launch of direct oral anticoagulants (DOACs), anticoagulant therapy has become more flexible, moving away from warfarin-based treatment. DOACs were considered safe to use without the need for monitoring or dose adjustment, but in recent years, it has become necessary to reevaluate their use. In this study, we aim to estimate the blood drug concentration range that will serve as an indicator of efficacy and safety, and to develop a simple evaluation method, with the aim of implementing appropriate anticoagulant therapy. By analyzing the results of a phase 3 trial comparing them with warfarin, we were able to estimate the risk range of blood Xa inhibitor concentrations. We also developed a measurement system that can be evaluated using an absorption spectrophotometer, and were able to measure the Xa inhibitor concentration.

Academic Significance and Societal Importance of the Research Achievements

直接経口抗凝固薬はワルファリンと異なり用量調整が不可能である。多くの患者は、常用量で安全かつ有効に使用できるが、高齢者や併用薬が多い患者などは、安全に使用できるとは限らない。本研究の成果は、特に出血リスクが高くなる血中濃度域を明らかにできたため、血中濃度が変化しやすい病態の患者を抽出し、適切な抗凝固療法の施行に貢献できると考えられる。一方、直接経口抗凝固薬の血中濃度測定は液体クロマトグラフィー質量分析計が専らであり、設備の面で測定できる施設はかなり限られる。直接経口抗凝固薬はその血中濃度と標的酵素の阻害活性に相関関係があり、既報の条件を応用することで、特別な設備がなくとも血中濃度を評価できた。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (1 results)

All 2022

All Presentation (1 results)

  • [Presentation] 汎発性血管内血液凝固症治療薬トロンボモデュリン アルファの効果・副作用に関する理論的解析2022

    • Author(s)
      片桐文彦、田中(鳩山)紗緒里、坂本麻衣子、今浦将治、木村耕二、高柳理早、山田安彦
    • Organizer
      第43回日本臨床薬理学会学術総会
    • Related Report
      2022 Research-status Report

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Published: 2021-04-28   Modified: 2025-01-30  

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