Why the study?
DOACs are effective for deep vein thrombosis, but their use can be challenging in patients with major thrombophilia carrying a high thrombotic risk.
Are direct oral anticoagulants effective and safe for the treatment and prevention of venous thromboembolism in patients with major congenital thrombophilia?
Cohort (n=45)
No
Are direct oral anticoagulants effective and safe for the treatment and prevention of venous thromboembolism in patients with major congenital thrombophilia?
In a real-world cohort of patients with major congenital thrombophilia, DOACs were safe and effective for VTE treatment with no recurrent thrombotic or bleeding events over a median 29-month follow-up.
Answers are grounded in this paper and cite their sources.
May support DOAC use in major congenital thrombophilia; hypothesis-generating and requires prospective confirmation before practice change.
BACKGROUND: Thrombophilia is a condition that predisposes to a higher incidence of venous thromboembolisms (VTE), some also in atypical sites. Direct oral anticoagulants (DOACs) have proven to be effective in the treatment of deep vein thrombosis (DVT). However, their use can be sometimes challenging in particular settings of patients such as those with major thrombophilia - antithrombin, protein C and protein S deficiency, homozygous mutation of Factor V Leiden, homozygous mutation of Factor II G20210A, combined heterozygous mutation of factor V Leiden and Factor II G20210A - carrying a high thrombotic risk. PATIENTS AND METHODS: At our Center, 45 patients with major thrombophilia were treated with DOACs: 33 after an initial treatment with vitamin K antagonists (VKA) and 12 as first-line therapy for VTE. The median follow-up of DOACs treatment was 29 months. CONCLUSIONS: No patient presented hemorrhagic or thrombotic complications during DOAC therapy. DOACs have proven to be effective and safe in this real-life series of patients with major thrombophilia.
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Serrao et al. (2019) conducted a cohort in Major congenital thrombophilia with venous thromboembolism (n=45). Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists (historical/previous treatment) was evaluated on Hemorrhagic or thromboembolic complications.
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