The Dose-Dependent Antiangiogenic Potential of Apixaban: An Experimental Outlook

Abstract

Aim: Direct oral anticoagulants (DOACs) are good alternatives to conventional medical regimens for the treatment and prevention of thromboembolism. Apixaban is one of the more popular variations of these newly developed drugs. Aside from its anticoagulant potential, possible cellular effects remain a topic for future studies. The object of this study was to investigate the possible antiangiogenic effects of apixaban in the chorioallantoic membrane (CAM) model. Method: Drug pellets were prepared at 10-4, 10-5, and 10-6 M concentrations of apixaban and were placed in the chorioallantoic membrane on the fourth day of egg incubation. On the eighth day, all vascular densities of the membranes were compared with a 10-6 M concentration of bevacizumab, which is a known monoclonal, humanized, vascular endothelial growth-factor inhibitor. Results: We find that a 10-4 M concentration of apixaban has strong antiangiogenic potential similar to that of bevacizumab. However, there was moderate antiangiogenic potential at a lower dose of apixaban (10-5 M, 10-6 M). A comparison of the higher doses of antiangiogenic potential (10-4 M concentration) with lower doses of apixaban (10-5 M, 10-6 M) revealed significant statistical differences (p < 0.05). Conclusion: Our results indicate that a high dose of apixaban has strong antiangiogenic potential. The exact mechanism of this effect remains unknown. These pilot results should be confirmed with further studies to obtain an updated look at DOACs.