Why the study?
Data on the efficacy and safety of DOACs for primary prevention in individuals with severe inherited thrombophilia and no personal history of thrombosis are lacking.
Does primary prevention with low-dose DOACs prevent VTE in patients with severe inherited thrombophilia without a personal history of thrombosis?
Does primary prevention with low-dose DOACs prevent VTE in patients with severe inherited thrombophilia without a personal history of thrombosis?
The authors propose considering low-dose DOACs for primary VTE prevention in select patients with severe inherited thrombophilia based on individual risk factors.
Low-dose DOAC primary prevention in severe thrombophilia lacks data; hypothesis-generating and should not change practice.
Direct oral anticoagulants (DOACs) are widely used in several indications, but data on their efficacy and safety in individuals affected by severe inherited thrombophilia, yet without any personal history of thrombosis, is lacking. Severe inherited thrombophilia abnormalities, especially antithrombin deficiency, confer a higher risk of developing venous thromboembolism (VTE) than is the case in the general population. In this article, we propose primary prevention with low-dose DOACs for certain patients with severe inherited thrombophilia but without any personal history of VTE, while taking into consideration the type of thrombophilia, family history, comorbidities, and bleeding risk.
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Krumb et al. (2021) studied this question.
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