Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS)
Abstract Background The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing recently, there is no compelling evidence indicating that those medications...
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doaj-bb1f08c30d9a412ab85ff55b77e359a62020-11-25T03:27:10ZengBMCAdvances in Rheumatology2523-31062020-05-0160111410.1186/s42358-020-00125-9Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS)Gustavo Guimarães Moreira Balbi0Marcelo de Souza Pacheco1Odirlei Andre Monticielo2Andreas Funke3Adriana Danowski4Mittermayer Barreto Santiago5Henrique Luiz Staub6Jozelia Rêgo7Danieli Castro Oliveira de Andrade8Serviço de Reumatologia, Hospital Universitário, Universidade Federal de Juiz de Fora (UFJF)Serviço de Reumatologia, Hospital Federal dos Servidores do Estado (HFSE)Serviço de Reumatologia, Departamento de Medicina Interna, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFGRS)Serviço de Reumatologia, Hospital de Clínicas, Universidade Federal do Paraná (UFPR)Serviço de Reumatologia, Hospital Federal dos Servidores do Estado (HFSE)Serviço de Reumatologia, Universidade Federal da Bahia (HUPES) e Escola Baiana de Medicina e Saúde PúblicaServiço de Reumatologia, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)Serviço de Reumatologia, Faculdade de Medicina, Universidade Federal de Goiás (UFG)Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo (USP)Abstract Background The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing recently, there is no compelling evidence indicating that those medications are safe in all antiphospholipid syndrome (APS) patients. Methodology To address this issue, specialists from the Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology performed a comprehensive review of the literature regarding DOACs use in APS to answer the three following questions: (1) potential mechanisms of action of these drugs that could be relevant to APS pathogenesis, (2) DOACs interference on lupus anticoagulant testing, and (3) the efficacy of DOACs in APS. Position statement After critically reviewing the relevant evidence, the authors formulated 8 Position Statements about DOACs use in APS. Conclusion DOACs should not be routinely used in APS patients, especially in those with a high-risk profile (triple positivity to aPL, arterial thrombosis, and recurrent thrombotic events). In addition, DOACs interferes with LA testing, leading to false-positive results in patients investigating APS.http://link.springer.com/article/10.1186/s42358-020-00125-9Antiphospholipid syndromeFactor Xa inhibitorsRivaroxabanApixabanEdoxabanAntithrombins |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gustavo Guimarães Moreira Balbi Marcelo de Souza Pacheco Odirlei Andre Monticielo Andreas Funke Adriana Danowski Mittermayer Barreto Santiago Henrique Luiz Staub Jozelia Rêgo Danieli Castro Oliveira de Andrade |
spellingShingle |
Gustavo Guimarães Moreira Balbi Marcelo de Souza Pacheco Odirlei Andre Monticielo Andreas Funke Adriana Danowski Mittermayer Barreto Santiago Henrique Luiz Staub Jozelia Rêgo Danieli Castro Oliveira de Andrade Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) Advances in Rheumatology Antiphospholipid syndrome Factor Xa inhibitors Rivaroxaban Apixaban Edoxaban Antithrombins |
author_facet |
Gustavo Guimarães Moreira Balbi Marcelo de Souza Pacheco Odirlei Andre Monticielo Andreas Funke Adriana Danowski Mittermayer Barreto Santiago Henrique Luiz Staub Jozelia Rêgo Danieli Castro Oliveira de Andrade |
author_sort |
Gustavo Guimarães Moreira Balbi |
title |
Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) |
title_short |
Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) |
title_full |
Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) |
title_fullStr |
Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) |
title_full_unstemmed |
Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS) |
title_sort |
antiphospholipid syndrome committee of the brazilian society of rheumatology position statement on the use of direct oral anticoagulants (doacs) in antiphospholipid syndrome (aps) |
publisher |
BMC |
series |
Advances in Rheumatology |
issn |
2523-3106 |
publishDate |
2020-05-01 |
description |
Abstract Background The term Direct Oral Anticoagulants (DOACs) refers to a group of drugs that inhibit factor Xa or thrombin. Even though their use for treating different thrombotic or prothrombotic conditions is increasing recently, there is no compelling evidence indicating that those medications are safe in all antiphospholipid syndrome (APS) patients. Methodology To address this issue, specialists from the Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology performed a comprehensive review of the literature regarding DOACs use in APS to answer the three following questions: (1) potential mechanisms of action of these drugs that could be relevant to APS pathogenesis, (2) DOACs interference on lupus anticoagulant testing, and (3) the efficacy of DOACs in APS. Position statement After critically reviewing the relevant evidence, the authors formulated 8 Position Statements about DOACs use in APS. Conclusion DOACs should not be routinely used in APS patients, especially in those with a high-risk profile (triple positivity to aPL, arterial thrombosis, and recurrent thrombotic events). In addition, DOACs interferes with LA testing, leading to false-positive results in patients investigating APS. |
topic |
Antiphospholipid syndrome Factor Xa inhibitors Rivaroxaban Apixaban Edoxaban Antithrombins |
url |
http://link.springer.com/article/10.1186/s42358-020-00125-9 |
work_keys_str_mv |
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