Direct oral anticoagulants in antiphospholipid syndrome: a real life case series

• Published in: Lupus Vol. 25; no. 6; pp. 658 - 662
• Main Authors: Betancur, J F, Bonilla-Abadía, F, Hormaza, A A, Jaramillo, F J, Cañas, C A, Tobón, G J
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.05.2016; Sage Publications Ltd
• Subjects: Administration, Oral; Adult; Aged; Anticoagulants; Anticoagulants - administration & dosage; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Antiphospholipid syndrome; Antiphospholipid Syndrome - complications; Antiphospholipid Syndrome - drug therapy; Autoimmune diseases; Bleeding; Coagulation; Female; Follow-Up Studies; Hemorrhage - chemically induced; Hemorrhage - epidemiology; Humans; Middle Aged; Pyrazoles - adverse effects; Pyrazoles - therapeutic use; Pyridones - adverse effects; Pyridones - therapeutic use; Recurrence; Retrospective Studies; Rivaroxaban - adverse effects; Rivaroxaban - therapeutic use; Standardization; Thrombosis; Thrombosis - etiology; Thrombosis - prevention & control; Treatment Outcome; Warfarin; Warfarin - adverse effects; Warfarin - therapeutic use; direct oral anticoagulants; thrombosis; anticoagulation; Antiphospholipid syndrome
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/0961203315624555

Aim The aim of this study was to describe a case series of patients with primary or secondary antiphospholipid syndrome (APS) treated with direct oral anticoagulants (DOACs). Patients and methods Clinical charts of eight patients with thrombotic primary or secondary APS treated with direct oral anticoagulants (DOACs) between January 2012 and May 2015 were reviewed. Results The mean age was 45 ± 14.36 (range 27–69 years). Four patients had secondary APS (50%). All patients were initially treated with warfarin by a mean time of 70.87 ± 57.32 months (range 17–153 months). Changes in anticoagulation were defined by recurring thrombosis in five patients (62.5%) and life-threatening bleeding in the other three cases. Seven patients (87.5%) received rivaroxaban treatment and one patient (12.5%) apixaban. The mean follow-up period with DOACs was 19 ± 10.06 months (range 2–36 months). There was no recurrence of thrombosis by the time of data collection. Conclusions Despite not being the standard treatment in APS, we propose DOACs as a rational alternative for the management of patients with this diagnosis. Further interventional clinical studies are necessary for possible standardization of this therapy in APS patients.