• Medicina clinica · Dec 2024

    Direct oral anticoagulants versus vitamin K antagonists in patients with thrombotic antiphospholipid syndrome: A prospective observational analysis.

    • Pablo Demelo-Rodríguez, Tatiana Pire-García, Sergio Moragón-Ledesma, Lucía Ordieres-Ortega, Francisco Galeano-Valle, and Rubén Alonso-Beato.
    • Venous Thromboembolism Unit of Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain; School of Medicine, University Complutense of Madrid, Spain; Sanitary Research Institute Gregorio Marañón, Madrid, Spain. Electronic address: pbdemelo@hotmail.com.
    • Med Clin (Barc). 2024 Dec 9.

    BackgroundThe role of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in the treatment of venous thromboembolism (VTE) in patients with antiphospholipid syndrome remains uncertain.MethodsWe conducted a prospective observational study on APS patients with VTE treated with VKAs or DOACs in a tertiary hospital from 2010 to 2023. Clinical characteristics, recurrent arterial or VTE events, and hemorrhagic complications were analyzed over a one-year follow-up.ResultsFifty APS patients were included: 31 (62%) treated with VKAs and 19 (38%) with DOACs. Thrombotic recurrences occurred in 5 VKA patients (16.1%) and 3 DOAC patients (15.8%). Major bleeding occurred in 2 VKA patients (6.45%) and none in the DOAC group. There were no significant differences in thrombotic recurrence (OR 1.01; 95% CI: 0.19-5.46) or major bleeding (OR 1.09; 95% CI: 0.14-8.52) between groups.ConclusionIn APS patients with VTE, DOACs showed similar rates of recurrent thrombosis and major bleeding compared to VKAs. Future studies should therefore focus on the role of DOACs in APS patients with varying clinical and serological profiles.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

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