|
|
Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome : a longitudinal cohort study
| Title: | Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome : a longitudinal cohort study |
| Authors: | Sato, T. Browse this author | | Nakamura, H. Browse this author | | Fujieda, Y. Browse this author →KAKEN DB | | Ohnishi, N. Browse this author | | Abe, N. Browse this author | | Kono, M. Browse this author | | Kato, M. Browse this author | | Oku, K. Browse this author | | Bohgaki, T. Browse this author | | Amengual, O. Browse this author | | Yasuda, S. Browse this author | | Atsumi, T. Browse this author →KAKEN DB |
| Keywords: | Antiphospholipid syndrome | | factor Xa inhibitor | | hemorrhage | | thrombosis | | warfarin |
| Issue Date: | 21-Oct-2019 |
| Publisher: | SAGE Publications |
| Journal Title: | Lupus |
| Volume: | 28 |
| Issue: | 13 |
| Start Page: | 1577 |
| End Page: | 1582 |
| Publisher DOI: | 10.1177/0961203319881200 |
| Abstract: | Objective The objective of this study was to clarify the efficacy and safety of factor Xa inhibitors for antiphospholipid syndrome patients in real world utilization. Methods This is a retrospective cohort study comprised of all consecutive patients with antiphospholipid syndrome in our department over a period of 28 years. Patients treated with factor Xa inhibitors were extracted from the cohort. As a control group, patients treated with warfarin were selected from the same cohort with matched age, gender, coexistence of systemic lupus erythematosus, and the presence of antiplatelet therapy, after which we used a propensity score for each of the risk factors as an additional covariate in multivariate Cox proportional hazard regression. The primary endpoint was set as thrombotic and hemorrhagic event-free survival for five years. Results Among 206 patients with antiphospholipid syndrome, 18 had a history of anti-Xa therapy (five rivaroxaban, 12 edoxaban, one apixaban). Fourteen out of 18 patients on anti-Xa therapy had switched to factor Xa inhibitors from warfarin. Event-free survival was significantly shorter during anti-Xa therapy than that during warfarin therapy (hazard ratio: 12.1, 95% confidence interval: 1.73-248, p = 0.01) (Figure 1(a)). Similarly, event-free survival in patients treated with factor Xa inhibitors was significantly shorter compared with controls (hazard ratio: 4.62, 95% confidence interval: 1.54-13.6, p = 0.0075). In the multivariate Cox proportional hazard model, event-free survival in patients with anti-Xa therapy remained significantly shorter (hazard ratio: 11.9, 95% confidence interval: 2.93-56.0, p = 0.0005). Conclusions Factor Xa inhibitors may not be recommended for antiphospholipid syndrome. |
| Rights: | T Sato , H Nakamura, Y Fujieda , N Ohnishi, N Abe , M Kono, M Kato, K Oku, T Bohgaki, O Amengual,S Yasuda and T Atsumi, Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome: a longitudinal cohort study, Lupus, 28, pp. 1577-1582. Copyright c 2019 The Author(s). DOI: 10.1177/0961203319881200 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/76206 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
Submitter: 藤枝 雄一郎
|
