Cargando…

Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry

Background: The particular challenge in dealing with patients with thromboembolic antiphospholipid syndrome (APS) is to establish an adequate therapy regime, as patients suffer from an increased risk of relapse despite antithrombotic treatment (ATT). Vitamin K antagonists (VKA) are the standard medi...

Descripción completa

Detalles Bibliográficos
Autores principales: Schulz, Annabel, Herrmann, Eva, Ott, Olivia, Lindhoff-Last, Edelgard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409774/
https://www.ncbi.nlm.nih.gov/pubmed/36013082
http://dx.doi.org/10.3390/jcm11164845
_version_ 1784774933261320192
author Schulz, Annabel
Herrmann, Eva
Ott, Olivia
Lindhoff-Last, Edelgard
author_facet Schulz, Annabel
Herrmann, Eva
Ott, Olivia
Lindhoff-Last, Edelgard
author_sort Schulz, Annabel
collection PubMed
description Background: The particular challenge in dealing with patients with thromboembolic antiphospholipid syndrome (APS) is to establish an adequate therapy regime, as patients suffer from an increased risk of relapse despite antithrombotic treatment (ATT). Vitamin K antagonists (VKA) are the standard medication of choice. The current data on the use of direct oral anticoagulants (DOAC) in APS patients remain limited. Methods: The results of the retrospective APSantiCO registry are presented. In 80 patients with APS, the efficacy and safety of different ATT regimens were analyzed. Results: At the time of inclusion, 43.8% of patients were treated with VKA and 36.3% with DOAC. Medication regimes changed several times and 279 treatment phases were further analyzed with a total treatment length of 7529 months. The incidence of recurrent arterial thrombosis was significantly larger in the DOAC group compared with the VKA group (p < 0.001), while the incidence of recurrent venous thrombosis was comparable between both groups, as was the incidence of bleedings. Heavy menstrual bleeding was the most frequently observed bleeding complication. Conclusions: The data suggest that DOAC may be an alternative to VKA for APS patients with venous thromboembolism, while VKA should be used in APS-related arterial thrombosis.
format Online
Article
Text
id pubmed-9409774
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94097742022-08-26 Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry Schulz, Annabel Herrmann, Eva Ott, Olivia Lindhoff-Last, Edelgard J Clin Med Article Background: The particular challenge in dealing with patients with thromboembolic antiphospholipid syndrome (APS) is to establish an adequate therapy regime, as patients suffer from an increased risk of relapse despite antithrombotic treatment (ATT). Vitamin K antagonists (VKA) are the standard medication of choice. The current data on the use of direct oral anticoagulants (DOAC) in APS patients remain limited. Methods: The results of the retrospective APSantiCO registry are presented. In 80 patients with APS, the efficacy and safety of different ATT regimens were analyzed. Results: At the time of inclusion, 43.8% of patients were treated with VKA and 36.3% with DOAC. Medication regimes changed several times and 279 treatment phases were further analyzed with a total treatment length of 7529 months. The incidence of recurrent arterial thrombosis was significantly larger in the DOAC group compared with the VKA group (p < 0.001), while the incidence of recurrent venous thrombosis was comparable between both groups, as was the incidence of bleedings. Heavy menstrual bleeding was the most frequently observed bleeding complication. Conclusions: The data suggest that DOAC may be an alternative to VKA for APS patients with venous thromboembolism, while VKA should be used in APS-related arterial thrombosis. MDPI 2022-08-18 /pmc/articles/PMC9409774/ /pubmed/36013082 http://dx.doi.org/10.3390/jcm11164845 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schulz, Annabel
Herrmann, Eva
Ott, Olivia
Lindhoff-Last, Edelgard
Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title_full Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title_fullStr Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title_full_unstemmed Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title_short Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry
title_sort thromboembolic antiphospholipid syndrome (aps): efficacy and safety of different anticoagulants-results of the apsantico registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409774/
https://www.ncbi.nlm.nih.gov/pubmed/36013082
http://dx.doi.org/10.3390/jcm11164845
work_keys_str_mv AT schulzannabel thromboembolicantiphospholipidsyndromeapsefficacyandsafetyofdifferentanticoagulantsresultsoftheapsanticoregistry
AT herrmanneva thromboembolicantiphospholipidsyndromeapsefficacyandsafetyofdifferentanticoagulantsresultsoftheapsanticoregistry
AT ottolivia thromboembolicantiphospholipidsyndromeapsefficacyandsafetyofdifferentanticoagulantsresultsoftheapsanticoregistry
AT lindhofflastedelgard thromboembolicantiphospholipidsyndromeapsefficacyandsafetyofdifferentanticoagulantsresultsoftheapsanticoregistry