Efficacy and safety of Apixaban in the treatment of cerebral venous sinus thrombosis: a multi-center study.

Apixaban cerebral sinus and venous thrombosis (CSVT) direct oral anticoagulants (DOAC) stroke vitamin K antagonists (VKA)

Journal

Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899

Informations de publication

Date de publication:
2024
Historique:
received: 20 03 2024
accepted: 01 05 2024
medline: 31 5 2024
pubmed: 31 5 2024
entrez: 31 5 2024
Statut: epublish

Résumé

Information regarding the safety and efficacy of specific direct oral anticoagulants (DOAC) in the treatment of cerebral sinus and venous thrombosis (CSVT) is scarce. Apixaban is one of the most frequently prescribed DOACs. Therefore, we aimed to compare the safety and efficacy of Apixaban with those of vitamin k antagonists (VKA) in patients with CSVT. Prospective CSVT databases from seven academic medical centers were retrospectively analyzed. Patients treated with Apixaban were compared to those treated with VKA. Data on demographics, clinical presentations, risk factors, radiological and outcome parameters were studied. Overall, 403 patients were included in the analysis. Of them, 48 (12%) were treated with Apixaban, and 355 (88%) were treated with VKA. Rates of coagulopathies were significantly higher in the VKA-treated patients but no other differences between the groups were found in baseline characteristics and underlying etiology. No significant differences were found between groups in efficacy or safety parameters including the rates of recanalization, favorable outcomes, one-year mortality, seizures, intracranial hemorrhage or CSVT recurrences. Our data suggests that Apixaban may be safe and effective for patients with CSVT. These results should be tested in prospective randomized clinical studies.

Sections du résumé

Background UNASSIGNED
Information regarding the safety and efficacy of specific direct oral anticoagulants (DOAC) in the treatment of cerebral sinus and venous thrombosis (CSVT) is scarce. Apixaban is one of the most frequently prescribed DOACs. Therefore, we aimed to compare the safety and efficacy of Apixaban with those of vitamin k antagonists (VKA) in patients with CSVT.
Methods UNASSIGNED
Prospective CSVT databases from seven academic medical centers were retrospectively analyzed. Patients treated with Apixaban were compared to those treated with VKA. Data on demographics, clinical presentations, risk factors, radiological and outcome parameters were studied.
Results UNASSIGNED
Overall, 403 patients were included in the analysis. Of them, 48 (12%) were treated with Apixaban, and 355 (88%) were treated with VKA. Rates of coagulopathies were significantly higher in the VKA-treated patients but no other differences between the groups were found in baseline characteristics and underlying etiology. No significant differences were found between groups in efficacy or safety parameters including the rates of recanalization, favorable outcomes, one-year mortality, seizures, intracranial hemorrhage or CSVT recurrences.
Conclusion UNASSIGNED
Our data suggests that Apixaban may be safe and effective for patients with CSVT. These results should be tested in prospective randomized clinical studies.

Identifiants

pubmed: 38817547
doi: 10.3389/fneur.2024.1404099
pmc: PMC11137185
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1404099

Informations de copyright

Copyright © 2024 Simaan, Metanis, Honig, Hallevi, Filioglo, Mendel, Barnea, Naftali, Auriel, Aladdin, Orion, Dally, Leker and Molad.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Naaem Simaan (N)

Department of Neurology, Ziv Medical Center, Safed, Israel.
The Azrieli Faculty of Medicine, Safed Bar Ilan University, Safed, Israel.

Issa Metanis (I)

Hadassah Departments of Neurology, Hebrew University Medical Center, Jerusalem, Israel.

Asaf Honig (A)

Hadassah Departments of Neurology, Hebrew University Medical Center, Jerusalem, Israel.

Hen Hallevi (H)

Department of Neurology and Stroke, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.

Andrei Filioglo (A)

Hadassah Departments of Neurology, Hebrew University Medical Center, Jerusalem, Israel.

Rom Mendel (R)

Department of Neurology, Assuta Ashdod Medical Center, Ashdod, Israel.

Rani Barnea (R)

Department of Neurology, Rabin Medical Center, Petah Tikva, Israel.

Jonathan Naftali (J)

Department of Neurology, Rabin Medical Center, Petah Tikva, Israel.

Eitan Auriel (E)

Department of Neurology, Rabin Medical Center, Petah Tikva, Israel.

Shorooq Aladdin (S)

Departments of Neurology, Sheba Medical Center, Ramat Gan, Israel.

David Orion (D)

Departments of Neurology, Sheba Medical Center, Ramat Gan, Israel.

Najib Dally (N)

The Azrieli Faculty of Medicine, Safed Bar Ilan University, Safed, Israel.
Department of Hematology, Ziv Medical Center, Safed, Israel.

Ronen R Leker (RR)

Hadassah Departments of Neurology, Hebrew University Medical Center, Jerusalem, Israel.

Jeremy Molad (J)

Department of Neurology and Stroke, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Classifications MeSH