Safety and efficacy of oral direct inhibitors of thrombin and factor Xa in antiphospholipid syndrome
Copyright © 2015 Elsevier B.V. All rights reserved..
BACKGROUND: Long-term anticoagulation is recommended in antiphospholipid syndrome with thrombosis in order to prevent recurrences. While the current mainstay relies on vitamin K antagonists, their long-term maintenance may remain challenging.
OBJECTIVES: To report on the safety and the efficacy of oral direct inhibitors of thrombin and factor Xa (ODIs) in antiphospholipid syndrome (APS).
METHODS: We performed a descriptive analysis of patients with APS enrolled in a French multicentre observational cohort between January 2012 and March 2014 and receiving ODIs. The main outcomes were the occurrence of a thrombotic recurrence or bleeding events.
RESULTS: Twenty-six patients with APS (primary in 12) received ODIs. Twenty patients had been previously treated with VKA (n=19), or fondaparinux (n=1) for a median duration of 3years. ODIs were introduced as second-line therapy because of INR lability/therapeutic simplification (n=17), recurrent thrombosis (n=1), VKA's associated bleeding event (n=1), and atrial fibrillation (n=1). Six patients received ODIs as first-line therapy. After a median [IQR] follow-up of 19 [8-29] months, one relapse of arterial thrombosis, two bleeding events (hypermenorrhea and rectal bleeding under rivaroxaban) and one recurrent migraine were reported, leading to discontinuation of therapy in these 4 patients.
CONCLUSION: ODIs might be an alternative therapeutic option in APS. Prospective studies are warranted to evaluate their safety in this condition.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Autoimmunity reviews - 14(2015), 8 vom: 21. Aug., Seite 680-5 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Noel, Nicolas [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 27.08.2015 Date Revised 16.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.autrev.2015.03.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM247961248 |
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| 245 | 1 | 0 | |a Safety and efficacy of oral direct inhibitors of thrombin and factor Xa in antiphospholipid syndrome |
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| 500 | |a Date Revised 16.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Long-term anticoagulation is recommended in antiphospholipid syndrome with thrombosis in order to prevent recurrences. While the current mainstay relies on vitamin K antagonists, their long-term maintenance may remain challenging | ||
| 520 | |a OBJECTIVES: To report on the safety and the efficacy of oral direct inhibitors of thrombin and factor Xa (ODIs) in antiphospholipid syndrome (APS) | ||
| 520 | |a METHODS: We performed a descriptive analysis of patients with APS enrolled in a French multicentre observational cohort between January 2012 and March 2014 and receiving ODIs. The main outcomes were the occurrence of a thrombotic recurrence or bleeding events | ||
| 520 | |a RESULTS: Twenty-six patients with APS (primary in 12) received ODIs. Twenty patients had been previously treated with VKA (n=19), or fondaparinux (n=1) for a median duration of 3years. ODIs were introduced as second-line therapy because of INR lability/therapeutic simplification (n=17), recurrent thrombosis (n=1), VKA's associated bleeding event (n=1), and atrial fibrillation (n=1). Six patients received ODIs as first-line therapy. After a median [IQR] follow-up of 19 [8-29] months, one relapse of arterial thrombosis, two bleeding events (hypermenorrhea and rectal bleeding under rivaroxaban) and one recurrent migraine were reported, leading to discontinuation of therapy in these 4 patients | ||
| 520 | |a CONCLUSION: ODIs might be an alternative therapeutic option in APS. Prospective studies are warranted to evaluate their safety in this condition | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Antiphospholipid syndrome | |
| 650 | 4 | |a Dabigatran | |
| 650 | 4 | |a Oral direct inhibitors | |
| 650 | 4 | |a Rivaroxaban | |
| 650 | 4 | |a Thrombosis | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Factor Xa Inhibitors |2 NLM | |
| 650 | 7 | |a Thrombin |2 NLM | |
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| 650 | 7 | |a Factor Xa |2 NLM | |
| 650 | 7 | |a EC 3.4.21.6 |2 NLM | |
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| 700 | 1 | |a Costedoat-Chalumeau, Nathalie |e verfasserin |4 aut | |
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| 700 | 1 | |a Sene, Damien |e verfasserin |4 aut | |
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| 700 | 1 | |a Michot, Jean-Marie |e verfasserin |4 aut | |
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| 700 | 1 | |a Saadoun, David |e verfasserin |4 aut | |
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