Association of risk factors and bleeding complications in Asian patients
taking edoxaban
Abstract
Aim: Asian patients are known to be more prone to bleeding complications
than patients of other ethnicities. Therefore, there are possibilities
of other risk factors that should be given special consideration for
dosage adjustment in this specific ethnic group. This study aimed to
investigate the risk factors for bleeding complications in Asian
patients under appropriate edoxaban dosage regimens. Methods: Data on
patients taking proper dosages, based on the Lixiana package insert,
were analyzed. Univariate and multivariable analyses were conducted to
evaluate associations between risk factors and bleeding outcomes.
Subgroup analysis was performed on high-risk patients for bleeding
complications whose edoxaban dose was reduced according to the package
insert. Results: A total of 346 patients were included. Among them, 32
patients experienced bleeding complications. Patients with either
weights of less than or equal to 60 kg and with cancer showed around
3.3- and 3.4-fold increased risk of bleeding complications compared to
heavier patients ( > 60 kg) and those without cancer,
respectively. In subgroup analysis with high-risk patients who took
low-dose edoxaban (15 mg and 30 mg), weights of less than or equal to 60
kg remained a significant factor for bleeding outcomes. Conclusion: This
study showed that weights of less than or equal to 60 kg and the
presence of cancers could affect bleeding complications which occurred
despite proper edoxaban treatment in Asian patients. Therefore, more
strict dosage guideline could be considered in populations with high
proportions of Asian ethnicities.