Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS).
Administration, Oral
Advisory Committees
Antiphospholipid Syndrome
/ drug therapy
Antithrombins
/ adverse effects
Brazil
Consensus
Contraindications, Drug
Drug Interactions
Drug Substitution
Humans
Lupus Coagulation Inhibitor
/ analysis
Observational Studies as Topic
Randomized Controlled Trials as Topic
Recurrence
Rheumatology
Societies, Medical
Thrombosis
/ drug therapy
Treatment Outcome
Antiphospholipid syndrome
Antithrombins
Apixaban
Dabigatran
Edoxaban
Factor Xa inhibitors
Rivaroxaban
Journal
Advances in rheumatology (London, England)
ISSN: 2523-3106
Titre abrégé: Adv Rheumatol
Pays: England
ID NLM: 101734172
Informations de publication
Date de publication:
27 05 2020
27 05 2020
Historique:
received:
28
10
2019
accepted:
08
04
2020
entrez:
29
5
2020
pubmed:
29
5
2020
medline:
7
9
2021
Statut:
epublish
Résumé
The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing recently, there is no compelling evidence indicating that those medications are safe in all antiphospholipid syndrome (APS) patients. To address this issue, specialists from the Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology performed a comprehensive review of the literature regarding DOACs use in APS to answer the three following questions: (1) potential mechanisms of action of these drugs that could be relevant to APS pathogenesis, (2) DOACs interference on lupus anticoagulant testing, and (3) the efficacy of DOACs in APS. After critically reviewing the relevant evidence, the authors formulated 8 Position Statements about DOACs use in APS. DOACs should not be routinely used in APS patients, especially in those with a high-risk profile (triple positivity to aPL, arterial thrombosis, and recurrent thrombotic events). In addition, DOACs interferes with LA testing, leading to false-positive results in patients investigating APS.
Sections du résumé
BACKGROUND
The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing recently, there is no compelling evidence indicating that those medications are safe in all antiphospholipid syndrome (APS) patients.
METHODOLOGY
To address this issue, specialists from the Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology performed a comprehensive review of the literature regarding DOACs use in APS to answer the three following questions: (1) potential mechanisms of action of these drugs that could be relevant to APS pathogenesis, (2) DOACs interference on lupus anticoagulant testing, and (3) the efficacy of DOACs in APS.
POSITION STATEMENT
After critically reviewing the relevant evidence, the authors formulated 8 Position Statements about DOACs use in APS.
CONCLUSION
DOACs should not be routinely used in APS patients, especially in those with a high-risk profile (triple positivity to aPL, arterial thrombosis, and recurrent thrombotic events). In addition, DOACs interferes with LA testing, leading to false-positive results in patients investigating APS.
Identifiants
pubmed: 32460902
doi: 10.1186/s42358-020-00125-9
pii: 10.1186/s42358-020-00125-9
doi:
Substances chimiques
Antithrombins
0
Lupus Coagulation Inhibitor
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM