Antiphospholipid antibody syndrome
Revision as of 03:03, 10 September 2018 by Benjamintillman (talk | contribs) (→Warfarin monotherapy )
| Section editors | |||
|---|---|---|---|
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Shruti Chaturvedi, MBBS, MSCI Baltimore, MD |
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Benjamin Tillman, MD Nashville, TN |
1 regimens on this page
1 variants on this page
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Guidelines
To be completed
All lines of therapy
Warfarin monotherapy
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Regimen
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Crowther et al. 2003 | Phase III (C) | High-intensity Warfarin (INR 3.1 to 4.0) | Seems not superior |
| Pengo et al. 2018 (TRAPS) | Phase III (C) | Rivaroxaban | Fewer events |
Note: Pengo et al. 2018 was closed prematurely due to excess events in the rivaroxaban arm.
Therapy
- Warfarin (Coumadin) PO titrated to goal INR 2.0 to 3.0
Continued indefinitely
References
- Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J, Laskin C, Fortin P, Anderson D, Kearon C, Clarke A, Geerts W, Forgie M, Green D, Costantini L, Yacura W, Wilson S, Gent M, Kovacs MJ. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med. 2003 Sep 18;349(12):1133-8. Erratum in: N Engl J Med. 2004 Jul 8;351(2):200. N Engl J Med. 2003 Dec 25;349(26):2577. link to original article PubMed
- Pengo V, Denas G, Zoppellaro G, Jose SP, Hoxha A, Ruffattia A, Andreoli L, Tincani A, Cenci C, Prisco D, Fierro T, Gresele P, Cafolla A, De Micheli V, Ghirarduzzi A, Tosetto A, Falanga A, Martinelli I, Testa S, Barcellona D, Gerosa M, Banzato A. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. Epub 2018 Jul 12. [Epub ahead of print] link to original article PubMed
Rivaroxaban monotherapy
Regimen
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Pengo et al. 2018 (TRAPS) | Phase III (C) | Warfarin | Seems inferior, excess events in rivaroxaban arm |
Note: Pengo et al. 2018 was closed prematurely due to excess events in the rivaroxaban arm.
Therapy
- Rivaroxaban (Xarelto) PO 20 mg PO once daily
Continued indefinitely
References
- Pengo V, Denas G, Zoppellaro G, Jose SP, Hoxha A, Ruffattia A, Andreoli L, Tincani A, Cenci C, Prisco D, Fierro T, Gresele P, Cafolla A, De Micheli V, Ghirarduzzi A, Tosetto A, Falanga A, Martinelli I, Testa S, Barcellona D, Gerosa M, Banzato A. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. Epub 2018 Jul 12. [Epub ahead of print] link to original article PubMed