新しい経口抗凝固薬 - JSEPTIC

1 20 ( ) Xa ( ) ( ) ( ) Xa Xa IF Tmax ( )1 41 31 41 2 12 17 5 9 12 9 11 6%100%( )50%50% 80%30 40%27%35% 35% 90%87%55% 1 2 1 1 1 2 1 1 P-gp 132 (75mg)372 (10mg)144 ( ) 232 (110mg)530 (15mg)265 (5mg)

2 CYP3A4 P-gp Xa 397 (15mg) (1) IF DI NVAF VTE 150mg 1 2 15mg 1 1 5mg 1 2 30mg 1 1 110mg 1 2 10mg 1 1 1 2 15mg 1 1 CrCL:30 50mL/min CrCL:15 49mL/min 80 80 P-gp 60kg CrCL:30 50mL/min 70 SC ( 2 ) ( ) CrCL 30mL CrCL 15mL CrCL 15mL CrCL 30mL ITCZ 1 (FLCZ ) HIV NVAF VTE Eur Heart J 2013 34 : 2094-2106 Am J Hematol.

3 2012;87:S141 S145 (CrCL 80mL/min) (CrCL:30-49mL/min) (CrCL 30ml/min) (CrCL:50-79mL/min) Eur Heart J 2013 34: 2094-2106 CrCL 80 CrCl 30 HIV ( ) P-gp CYP HIV CAM,EM Eur Heart J 2013 34: 2094-2106 DI 1 AUC Cmax 4 AUC Cmax ( ) P-gp P-gp Xa CYP CYP ( )

4 Xa 12 Xa PT-INR RE-LY RE-LY 110mg / 150mg / J-ROCKET AF 1,280 75 2 /TIA/ 15mg/ ROCKET AF ( ) ROCKET AF J-ROCKET AF ( ROCKET AF )

5 1 18 18,201 ARISTOTLE / ARISTOTLE 354 30mg 1 1 349 2000IU 1 2 11 14 IF ICU

6 43 RCT DVT/PE: primary outcome : secondary outcome : ICU J Thromb Haemast 2013.

7 11 122-128 APTT( 80 ) Xa PT APTT APTT PT PT Xa IF Eur Heart J 2013 34 : 2094-2106 ICU ( ) ( ) Eur Heart J 2013 34: 2094-2106 79 (RE-LY ) 2 (CrCL=36mL/min) ( ) 150mg 1 2 2 Blood 2012 119 2172 2174 DVT(POD7) POD56 TCT TCT ( 4 ) VII ( ) (Ph Ph )