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Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome : a longitudinal cohort study

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/76206

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: Nov-2019
Publisher: SAGE Publications
Journal Title: Lupus
Issue: 28
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

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