Direct oral anticoagulants in antiphospholipid syndrome

a real life case series

Betancur, J F
Bonilla-Abadía, F
Hormaza, A A
Jaramillo, F J
Cañas, C A
Tobón, G J

¹Department of Internal Medicine, Fundación Valle del Lili, Cali, Colombia. CES University School of Medicine, Medellín, Colombia
²Department of Internal Medicine, Division of Rheumatology, Fundación Valle del Lili Cali, Colombia. ICESI University, School of Medicine, Cali, Colombia
³Hematology Unit, Fundación Valle del Lili, Cali, Colombia

Dr Juan Felipe Betancur, Internal Medicine, Cra. 98 N. 18-49, Fundación Valle del Lili, Cali, Colombia. Email: [email protected]

Received May 29, 2015

Accepted December 7, 2015

Lupus 25(6):p 658-662, May 2016. | 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.