New Insights into the Use of Direct Oral Anticoagulants in Non-high Risk Thrombotic APS Patients: Literature Review and Subgroup Analysis from a Meta-analysis
| Autor: | Stéphane Zuily, Luc Darnige, Xin Jiang, Tatiana Reshetnyak, Xin-Xin Yan, Zhi-Cheng Jing, Ismaël Elalamy, Maria Vorobyeva, Grigorios Gerotziafas, Denis Wahl, Virginie Dufrost |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Subgroup analysis law.invention Dabigatran 03 medical and health sciences 0302 clinical medicine Rheumatology Randomized controlled trial law Antiphospholipid syndrome Internal medicine medicine Humans 030203 arthritis & rheumatology Rivaroxaban business.industry Anticoagulants Thrombosis medicine.disease Antiphospholipid Syndrome 030104 developmental biology Meta-analysis Cohort business medicine.drug |
| Zdroj: | Current rheumatology reports. 22(7) |
| ISSN: | 1534-6307 |
| Popis: | The efficacy of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) is discussed. Results from randomized controlled trials are available. It has been stated that a history of arterial thrombosis and triple positivity was associated with a higher risk of thrombosis in APS patients treated with DOACs. However, their efficacy in non-high-risk APS patients with isolated venous manifestations is unsolved. Therefore, we performed a sub-group analysis of a previously published meta-analysis after the exclusion of patients with triple positivity and those with history of arterial or small vessel thrombosis. We identified 290 APS patients with previous isolated venous event treated with DOACs; among them, 25 (8.6%) patients experienced a recurrent thrombosis in comparison to 16% in the original cohort. We found that the rate of recurrent thrombosis is lower in APS patients with isolated venous manifestations than in overall APS patients including high-risk patients. Research about DOAC use in non-high-risk APS patients needs to be continued. |
| Databáze: | OpenAIRE |
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