Pharmacokinetics of Rivaroxaban After Bariatric Surgery

Inclusion criteria

• Creatinine clearance measured by the Cockroft formula ≥ 60 mL / min
• Patient meeting the specific criteria of one of the 4 groups:
• morbidly obese patients with BMI ≥ 40
• Patients operated by gastric bypass for over a year and with stable weight
• Patients operated by sleeve gastrectomy for over a year and with stable weight
• Control group: non-operated subjects but with an age and a BMI corresponding to those of the patients of the 2 operated groups.

Exclusion criteria

• Indication for anticoagulant therapy, antiplatelet therapy or long-term nonsteroidal anti-inflammatory drugs
• Clinically significant bleeding in progress
• Taking oral or parenteral anticoagulants, or taking platelet antiaggregants within 4 weeks before inclusion
• Congenital or acquired hemorrhagic disorders (eg von Willebrand disease, hemophilia)
• Injury or disease, at significant risk of major bleeding (gastrointestinal ulceration, presence of malignant tumors with a high risk of bleeding, recent brain or spinal cord injury, recent cerebral, spinal or ophthalmic surgery, recent intracranial hemorrhage, known or suspected oesophageal varices , arteriovenous malformations, vascular aneurysms or major intraspinal or intracerebral vascular abnormalities)
• Severe uncontrolled arterial hypertension
• Active gastrointestinal disease potentially leading to bleeding disorders (esophagitis, gastritis, gastroesophageal reflux disease, chronic inflammatory bowel disease)
• Vascular retinopathy
• Bronchiectasis or history of pulmonary bleeding
• Hypersensitivity to the active substance or to any of the excipients of rivaroxaban
• Hepatic involvement associated with coagulopathy and clinically significant bleeding risk, including cirrhotic patients with Child Pugh Grade B or C score
• Concomitant use of potent inhibitors or inducers of CYP3A4 and / or P-gp (azole antifungal or HIV protease inhibitor)
• Participation in a paid and / or therapeutic study in the previous 3 months
• Pregnant or lactating women,
• Women of childbearing potential not using effective contraception