Key result
Edoxaban prevents recurrent VTE and bleeding for 1 year in cancer-associated antithrombin III deficiency.
Why the study?
Management of deep vein thrombosis and pulmonary thromboembolism in cancer patients with antithrombin III deficiency and fluctuating warfarin control is challenging.
Does edoxaban prevent VTE recurrence and bleeding in a cancer patient with antithrombin III deficiency?
Case Report (n=1)
No
Does edoxaban prevent VTE recurrence and bleeding in a cancer patient with antithrombin III deficiency?
Edoxaban may be a viable treatment option for VTE in cancer patients with antithrombin III deficiency who experience fluctuating INR on warfarin.
Answers are grounded in this paper and cite their sources.
Edoxaban maintained stable anticoagulation without events in this case; hypothesis-generating for antithrombin deficiency with chemotherapy and requires prospective confirmation.
A 57-year-old man with antithrombin III deficiency with deep vein thrombosis and pulmonary thromboembolism after surgery for colon cancer was managed with warfarin and inferior vena cava filtration. After starting chemotherapy for liver metastasis, the control of his prothrombin time-international normalized ratio in response to warfarin began to fluctuate. Warfarin was changed to edoxaban (an oral direct Factor Xa inhibitor), and he had no recurrence of venous thromboembolism or bleeding for approximately 1 year. We conclude that edoxaban could be a useful treatment option for complicated patients with deep vein thrombosis.
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Kawano et al. (2016) conducted a case report in Deep vein thrombosis and pulmonary thromboembolism with antithrombin III deficiency and cancer (n=1). Edoxaban vs. Warfarin was evaluated on Recurrence of venous thromboembolism or bleeding. Edoxaban successfully prevented the recurrence of venous thromboembolism and bleeding for 1 year in a cancer patient with antithrombin III deficiency whose PT-INR was difficult to control with warfarin.
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