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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

  • Antiphospholipid Syndrome (S Zuily, Section Editor)
  • Published:
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Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Inserm UMR_S 1116 and CHRU de Nancy, Vascular Medicine Division and Regional Competence Center For Rare Vascular And Systemic Autoimmune Diseases, Université de Lorraine, Nancy, France

    Virginie Dufrost, Denis Wahl & Stéphane Zuily

  2. Inserm UMR-S 1140, Service d’Hématologie Biologique, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France

    Luc Darnige

  3. Laboratory of Vascular Rheumatology, V.A. Nasonova Research Institute of Rheumatology, 115522, Kashirskoye Shosse 34a, Moscow, Russia

    Tatiana Reshetnyak & Maria Vorobyeva

  4. Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Xin Jiang & Zhi-Cheng Jing

  5. The Key Laboratory of Pulmonary Vascular Medicine, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China

    Xin-xin Yan

  6. Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale (INSERM) U938 and Institut Universitaire de Cancérologie, Faculté de Médecine, Sorbonne Université, Paris, France

    Grigorios Gerotziafas & Ismaël Elalamy

  7. Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France

    Grigorios Gerotziafas & Ismaël Elalamy

  8. I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Ismaël Elalamy

Authors
  1. Virginie Dufrost
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  2. Luc Darnige
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  3. Tatiana Reshetnyak
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  4. Maria Vorobyeva
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  5. Xin Jiang
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  6. Xin-xin Yan
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  7. Grigorios Gerotziafas
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  8. Zhi-Cheng Jing
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  9. Ismaël Elalamy
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  10. Denis Wahl
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  11. Stéphane Zuily
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Corresponding author

Correspondence to Stéphane Zuily.

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Conflict of Interest

Virginie DUFROST reports no conflict of interest.

Luc DARNIGE reports no conflict of interest.

Tatiana RESHETNYAK reports no conflict of interest.

Maria VOROBYEVA reports no conflict of interest.

Xin Jiang reports no conflict of interest.

Xin-xin YAN reports no conflict of interest.

Grigorios GEROTZIAFAS reports no conflict of interest.

Zhi-Cheng JING reports no conflict of interest.

Ismaël ELALAMY reports no conflict of interest.

Denis WAHL, MD reports no conflict of interest.

Stéphane ZUILY reports, outside the submitted work, support to attend scientific meetings with honoraria for lectures from Alliance Bristol-Myers Squibb-Pfizer Pharmaceuticals, Aspen, Bayer Healthcare, and GlaxoSmithKline.

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This article is part of the Topical Collection on Antiphospholipid Syndrome

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Dufrost, V., Darnige, L., Reshetnyak, T. et al. 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. Curr Rheumatol Rep 22, 25 (2020). https://doi.org/10.1007/s11926-020-00901-y

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