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Revista Colombiana de Reumatología
Print version ISSN 0121-8123
Abstract
RESTREPO CORREA, Ricardo César et al. Use of factor Xa inhibitors in antiphospholipid antibodies syndrome: A series of seven cases. Rev.Colomb.Reumatol. [online]. 2018, vol.25, n.1, pp.16-21. ISSN 0121-8123. https://doi.org/10.1016/j.rcreu.2017.07.004.
Background:
Antiphospholipid syndrome is an autoimmune disease with antibodies against membrane phospholipids with mainly thrombotic and/or obstetric manifestations. Its treatment is generally based on indefinite anticoagulation, usually with warfarin, and which, for various factors, is not always feasible, making it necessary to use alternative therapies.
Objective:
To describe the experience with rivaroxaban in patients with antiphospholipid syndrome.
Materials and methods:
A descriptive study was conducted on subjects that met the 2006 Sydney criteria for antiphospholipid antibodies syndrome and received anticoagulation with rivaroxaban at 20mg daily dose in 2 reference hospitals in Medellin, Colombia, between January 2012 and April 2015.
Results:
The study included 7 patients, with a mean age of 36±10.8 years (range 23-55). Four patients had venous thrombosis, 5 arterial, 5were positive for anticardiolipin antibodies, 3 reactive to lupus anticoagulant, 2 anti-β2 glycoprotein positive subjects, and one patient had triple antiphospholipid antibody positivity. The median time of warfarin use
was 15 months (RIQ 1-36). The reasons for starting rivaroxaban were: bleeding (n = 2), sub-therapeutic coagulation ranges (n = 2), toxicoderma, gastrointestinal intolerance, and re-thrombosis (n = 1, each). The time of use was 17.9±13.4 months (range: 3-34). There were 2 recurrent cases of thrombosis during follow-up, and no adverse events.
Conclusion:
The use of factor Xa inhibitors in a series of patients with antiphospholipid syndrome and unable to use warfarin showed an adequate safety profile; however, 2 recurrent episodes of venous thrombosis occurred.
Keywords : Rivaroxaban; Warfarin; Antiphospholipid síndrome; Rivaroxaban; Warfarin; Antiphospholipid syndrome.