does proton pump inhibition change the on-treatment anti-xa activity in xabans-treated patients with atrial fibrillation? a pilot study

Proton pump inhibition (ppi) reduces gastrointestinal bleeding on direct oral anticoagulants. however, ppi affect dabigatran on-treatment levels; and there is no information regarding the effect of ppi on xabans on-treatment activity. thus, the aim of this study was to determine the impact of ppi on therapeutic anti-xa activity in rivaroxaban- and apixaban-treated patients with atrial fibrillation (af). this single-centre pilot prospective study enrolled 77 consecutive xabans-treated patients (42 rivaroxaban-treated and 35 apixaban-treated patients) with af. ppi was administrated in 44 patients. trough and peak anti-xa activity was assessed with factor xa-calibrated anti-xa chromogenic analysis. there were no significant differences in trough anti-xa activity comparing ppi-treated patients and patients without ppi (80.5 ± 66.5 ng/ml in ppi group vs. 71.6 ± 64.1 ng/ml in non-ppi group, p = 0.57, table 2). similarly, there were no significant differences in peak anti-xa activity between compared groups (175.2 ± 102.5 ng/ml in ppi group vs. 202.9 ± 84.1 ng/ml in non-ppi group, p = 0.21). this pilot study did not reveal significant changes in xabans on-treatment anti-xa activity according the ppi status.