American Society of Hirudotherapy

A proposal for dose-adjustment of dabigatran etexilate in atrial fibrillation guided by thrombin time

Research article published in British journal of clinical pharmacology (2014)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsChin et al. · British journal of clinical pharmacology, 2014

Abstract

Dabigatran is an oral anticoagulant that is increasingly used for atrial fibrillation (AF). Presently, many authorities state that routine laboratory coagulation monitoring is not required. However, data have recently been published demonstrating that higher trough plasma dabigatran concentrations are associated with lower thromboembolic and higher haemorrhagic event rates. Using these data, we simulate a range of AF patients with varying risks for these events and derive a target range of trough plasma dabigatran concentrations (30-130 μg l(-1) ). Finally, we propose that a conventional screening coagulation assay, the thrombin time (TT), can be used to discern whether or not patients are within this range of dabigatran concentrations.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleResearch Support, Non-U.S. Gov'tReview
Indexed MeSH termsAtrial FibrillationBenzimidazolesDabigatranDose-Response Relationship, DrugDrug MonitoringFactor Xa InhibitorsHemorrhageHumansPyridinesThrombin TimeThromboembolism

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This paper proposed a strategy for individualizing dabigatran dosing in atrial fibrillation by deriving a target trough plasma concentration range (about 30 to 130 microg/L) from published exposure-event data and arguing that the thrombin time, a conventional coagulation screen, could indicate whether patients fall within that range. Its relevance to ASH is mechanistic and educational: dabigatran is an oral direct thrombin inhibitor, the same pharmacological class as hirudin and its leech-derived relatives, and the thrombin time is the very assay sensitive to such inhibitors, which illustrates how leech-anticoagulant biology connects to monitoring of modern thrombin-directed drugs. The caveat is that this is a modeling and proposal paper using simulation rather than a prospective clinical trial, and it concerns a synthetic small-molecule drug, so it offers conceptual context for the thrombin-inhibition story, not direct evidence about medicinal-leech treatment.

Citation

A proposal for dose-adjustment of dabigatran etexilate in atrial fibrillation guided by thrombin time.

Chin et al. · British journal of clinical pharmacology, 2014

DOI

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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