• PDF / 1,059,864 Bytes
• 9 Pages / 595.276 x 790.866 pts Page_size
• 25 Downloads / 232 Views

DOWNLOAD

REPORT

ORIGINAL ARTICLE

Direct oral anticoagulants in patients with severe inherited thrombophilia: a single‑center cohort study Joanna Zuk1,2 · Elzbieta Papuga‑Szela1 · Lech Zareba3 · Anetta Undas1,4  Received: 3 June 2020 / Revised: 22 September 2020 / Accepted: 24 September 2020 © Japanese Society of Hematology 2020

Abstract We investigated the safety and efficacy of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) associated with severe inherited thrombophilia. In this single-center cohort study, we enrolled 56 consecutive VTE patients with severe inherited thrombophilia, defined as the presence of antithrombin (n = 18), protein C (n = 12) and protein S (n = 12) deficiencies, homozygous Factor V Leiden (n = 3) and prothrombin G20210AA (n = 4) mutations, or combined defects (n = 7). During a median follow-up of 44.5 (IQR 30–52.5) months, rivaroxaban was used in 30 (53.6%), apixabanin 14 (25%), and dabigatran in 12 (21.4%) subjects. Recurrent nonfatal VTE was observed in 5 (8.9%) patients (2.4 per 100 patient-years), treated with rivaroxaban (n = 4) and apixaban (n = 1). Major bleeding and clinically relevant non-major bleeding (CRNMB) occurred in 2 (3.5%) and 4 (7%) subjects, respectively (0.96 per 100 patient-years and 1.92 per 100 patientyears, respectively), including 4 patients on rivaroxaban. The event-free survival analysis showed that the use of rivaroxaban was associated with increased risk of recurrent VTE or bleeding, compared with apixaban or dabigatran (HR 2.76, 95% CI 1.26–3.92, p = 0.039). In conclusion, the results of our cohort study indicate that full-dose dabigatran or apixaban are effective and safe in patients with severe inherited thrombophilia. Keywords  Severe inherited thrombophilia · Venous thromboembolism · Direct oral anticoagulants · Bleeding · Rivaroxaban

Introduction Inherited thrombophilia, including factor V Leiden (FVL) and prothrombin 20210A gene mutation being most commonly detected, involves genetic risk factors that predispose to venous thromboembolism (VTE). Deficiencies of protein C (PC), protein S (PS) or antithrombin (AT) are less prevalent (

Recommend Documents

Concomitant Use of Direct Oral Anticoagulants and Antiepileptic Drugs: A Prospective Cohort Study in Patients with Atria

189 51 828KB

Benefit of dual antithrombotic therapy with direct oral anticoagulants in patients with atrial fibrillation undergoing p

171 59 4MB

Prevention and Treatment of Bleeding with Direct Oral Anticoagulants

180 95 761KB

Weight gain in patients with severe atopic dermatitis treated with dupilumab: a cohort study

169 21 1MB

Direct oral anticoagulants good value for stroke prevention in AF

167 50 163KB

Effectiveness and Safety of Direct Oral Anticoagulants in the Secondary Stroke Prevention of Elderly Patients: Ljubljana

177 94 650KB

Direct oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation and cancer a meta-analysis

171 51 2MB

Efficacy and Safety of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Liver Disease: a Meta-Analysi

149 21 1MB

Direct Oral Anticoagulants in Patients with Liver Disease in the Era of Non-Alcoholic Fatty Liver Disease Global Epidemi

170 54 948KB

Overview and Practical Application of Coagulation Assays in Managing Anticoagulation with Direct Oral Anticoagulants (DO

112 51 911KB

Comparative Outcomes Between Direct Oral Anticoagulants, Warfarin, and Antiplatelet Monotherapy Among Chinese Patients w

146 16 1MB

Periprocedural and long-term safety and feasibility of direct oral anticoagulants in patients with biological valve unde

131 19 555KB