Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis

Introduction: Cerebral venous thrombosis (CVT) is a life-threatening neurological condition. There is limited evidence for the use of direct oral anticoagulants (DOAC) for long-term anticoagulation in this patient population. We report a case series of patients treated with apixaban and their clinic...

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Autores principales: Bharath, Suman Preet, Arshad, Hasnain, Song, Yong-Bum, Kirmani, Jawad F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893101/
https://www.ncbi.nlm.nih.gov/pubmed/36700247
http://dx.doi.org/10.1177/10760296221129591
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author Bharath, Suman Preet
Arshad, Hasnain
Song, Yong-Bum
Kirmani, Jawad F.
author_facet Bharath, Suman Preet
Arshad, Hasnain
Song, Yong-Bum
Kirmani, Jawad F.
author_sort Bharath, Suman Preet
collection PubMed
description Introduction: Cerebral venous thrombosis (CVT) is a life-threatening neurological condition. There is limited evidence for the use of direct oral anticoagulants (DOAC) for long-term anticoagulation in this patient population. We report a case series of patients treated with apixaban and their clinical course. Methods: This was a retrospective cohort study. Patients diagnosed with CVT in a defined time period at our institution were screened for long-term anticoagulation and patients who were treated with apixaban were included in this study. Results: A total of nine patients were included in this study. The mean age was 36 years and 56% of the patients included were women. All received initial anticoagulation with unfractionated heparin (UFH) infusion for at least twenty-four hours, except for one patient who had anti-thrombin III deficiency and was treated with argatroban infusion. For long-term anticoagulation, 56% of patients received apixaban 10 mg twice daily for the first five to seven days followed by 5 mg twice daily, while the remaining 44% were transitioned from IV anticoagulation to apixaban 5 mg twice daily. There were no adverse events reported, except for one patient who developed anemia after 7 months of treatment and required a blood transfusion. Complete recanalization was achieved in 78% while 22% had partial recanalization. Follow-up time ranged from six to twenty-three months. Conclusion: The use of apixaban for long-term anticoagulation in CVT resulted in recanalization in all of the patients in this case series without any major side effects. This case series adds to the emerging studies demonstrating the utility of apixaban for CVT.
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spelling pubmed-98931012023-02-03 Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis Bharath, Suman Preet Arshad, Hasnain Song, Yong-Bum Kirmani, Jawad F. Clin Appl Thromb Hemost Original Manuscript Introduction: Cerebral venous thrombosis (CVT) is a life-threatening neurological condition. There is limited evidence for the use of direct oral anticoagulants (DOAC) for long-term anticoagulation in this patient population. We report a case series of patients treated with apixaban and their clinical course. Methods: This was a retrospective cohort study. Patients diagnosed with CVT in a defined time period at our institution were screened for long-term anticoagulation and patients who were treated with apixaban were included in this study. Results: A total of nine patients were included in this study. The mean age was 36 years and 56% of the patients included were women. All received initial anticoagulation with unfractionated heparin (UFH) infusion for at least twenty-four hours, except for one patient who had anti-thrombin III deficiency and was treated with argatroban infusion. For long-term anticoagulation, 56% of patients received apixaban 10 mg twice daily for the first five to seven days followed by 5 mg twice daily, while the remaining 44% were transitioned from IV anticoagulation to apixaban 5 mg twice daily. There were no adverse events reported, except for one patient who developed anemia after 7 months of treatment and required a blood transfusion. Complete recanalization was achieved in 78% while 22% had partial recanalization. Follow-up time ranged from six to twenty-three months. Conclusion: The use of apixaban for long-term anticoagulation in CVT resulted in recanalization in all of the patients in this case series without any major side effects. This case series adds to the emerging studies demonstrating the utility of apixaban for CVT. SAGE Publications 2023-01-25 /pmc/articles/PMC9893101/ /pubmed/36700247 http://dx.doi.org/10.1177/10760296221129591 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Bharath, Suman Preet
Arshad, Hasnain
Song, Yong-Bum
Kirmani, Jawad F.
Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title_full Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title_fullStr Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title_full_unstemmed Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title_short Long-term Anticoagulation with Apixaban in Patients with Cerebral Venous Thrombosis
title_sort long-term anticoagulation with apixaban in patients with cerebral venous thrombosis
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893101/
https://www.ncbi.nlm.nih.gov/pubmed/36700247
http://dx.doi.org/10.1177/10760296221129591
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