ASPIRE-level

Written By Muhan Yeo

The ASPIRE (the efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with atrial fibrillation) study is a prospective, multicenter, non-interventional observational study in Korea, focusing on adults with non-valvular atrial fibrillation (AF) receiving apixaban.

This cohort has led to multiple studies, including the ASPIRE-level study, which investigated the pharmacokinetics of apixaban in relation to dose reduction criteria and off-label dosing using anti-Xa and thrombin generation assays.

Anti-factor Xa assay. Adapted from Clinical implication of monitoring rivaroxaban and apixaban by using anti-factor Xa assay in patients with non-valvular atrial fibrillation, Ikeda K, Tachibana H., J Arrhythm. 2016;32(1):42-50, licensed under CC BY-NC-ND 4.0.

The off-label underdosed apixaban leads to significantly lower plasma apixaban concentrations than on-label reduced and standard doses. Furthermore, a substantial proportion of patients exhibit apixaban concentrations outside the expected range, suggesting potential benefits of plasma concentration monitoring.

Muhan Yeo
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