• Medicina clinica · Jul 2023

    Review

    Direct-acting oral anticoagulants in antiphospholipid syndrome: A systematic review.

    • José Antonio Girón-Ortega and José Antonio Girón-González.
    • Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: jagironortega@gmail.com.
    • Med Clin (Barc). 2023 Jul 21; 161 (2): 657765-77.

    AbstractThe objective of the systematic review is to analyze the efficacy of direct-acting oral anticoagulants (DOAC) in the prophylaxis of thrombosis in antiphospholipid syndrome (APS). We searched for clinical trials, cohort studies and meta-analyses published from January 1, 2012 to September 30, 2022. Articles that analyzed the efficacy of DOAC in the prevention of thrombosis recurrence, with or without comparison with antivitamin K (VKA) drugs, were selected. DOACs, specifically rivaroxaban and apixaban, were significantly less effective than VKAs in preventing recurrence of thrombosis in patients with APS and prior arterial thrombosis or the concomitant presence of two or three different antiphospholipid antibodies. The proportion of patients with severe bleeding as side effect are similar in those treated with DOAC and with VKA. The results argue against the use of DOAC in the treatment of patients with thrombotic APS.Copyright © 2023 Elsevier España, S.L.U. All rights reserved.

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