Apixaban/warfarin
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Calciphylaxis and bleeding event: 18 case reports A retrospective study of 20 patients identified through an electronic database search between 1 January 2014 and 1 December 2017, described 18 patients, of whom 17 patients including 9 women and 8 men [not all exact ages stated] developed calciphylaxis during treatment with warfarin for atrial fibrillation (AF) or deep vein thrombosis (DVT), and a 54-year-old woman developed bleeding during treatment with apixaban for AF. Additionally, three of the patients with calciphylaxis developed bleeding from fistula site/haematoma, bleeding at the site of vacuum-assisted closure device or haemoptysis during treatment with apixaban for AF [not all dosages, routes and outcomes stated]. The patients, who were diagnosed with end-stage renal disease, had been undergoing haemodialysis (15 patients) and peritoneal dialysis (3 patients). Out of these 18 patients, 17 patients received treatment with warfarin for AF (15 patients) and DVT (2 patients). At the time of dialysis initiation, 5 out of these 17 patients had been receiving warfarin therapy, while 9 patients did not receive warfarin and data was not stated in 3 patients. However, at the time of calciphylaxis diagnosis, 16 out of 17 patients had been receiving warfarin therapy and data was not stated in 1 patient. After 0–12 months of lesion onset, the patients were diagnosed with calciphylaxis. Therefore, warfarin therapy was stopped 0–34 months after the onset of lesion in 16 patients. Out of these 16 patients, warfarin therapy was stopped 3 months after the lesion onset in 2 patients, which resulted in the improvement in calciphylaxis. However, calciphylaxis recurred in these 2 patients. Of these 16 patients, warfarin therapy was stopped in
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