Oral direct inhibitors may be an alternative therapy for antiphospholipid syndrome

New oral direct thrombin and factor Xa inhibitors may be alternative therapeutic options for patients with antiphospholipid syndrome, according to researchers.

Twenty-four patients with antiphospholipid syndrome (APS) were enrolled in a French multicenter, observational, cohort study between January 2012 and March 2014 and were prescribed oral direct thrombin and factor Xa inhibitors (ODIs). Median age at diagnosis was 41, and median duration of disease was 3 years at baseline.

The researchers retrospectively reviewed patients’ clinical, biological and therapeutic data. Study outcomes included occurrence of thrombotic recurrence and occurrence of adverse events.

Anticardiolipin antibodies were observed in 21 patients, lupus anticoagulant antibodies were observed in 16 and immunoglobulin G anti-beta-2-glycoprotein were observed in 6 patients.

ODIs included dabigatran in 11 patients and rivaroxaban in 13 patients. Nineteen patients had prior treatment with vitamin K antagonists.

Five patients received ODIs as first-line therapy and the remaining 19 received ODIs as second-line therapy.

After a median follow-up of 15 months, four patients discontinued treatment due to adverse events; one of the four patients experienced relapse of arterial thrombosis, two experienced bleeding events and one experienced recurrent migraines. At 12 months, the event-free survival rate was 86.6% using Kaplan-Meier curve analysis, according to the researchers. – by Shirley Pulawski

Reference:

Noel N, et al. Paper #8. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: The authors have relevant financial disclosures.