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

Sato, T.; Nakamura, H.; Fujieda, Y.; Ohnishi, N.; Abe, N.; Kono, M.; Kato, M.; Oku, K.; Bohgaki, T.; Amengual, O.; Yasuda, S.; Atsumi, T.

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

Sato, T.; Nakamura, H.; Fujieda, Y. et al.

Lupus, 2019, 28(13), 1577-1582

Permalink : https://hdl.handle.net/2115/76206

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/76206
タイトル	Factor Xa inhibitors for preventing recurrent thrombosis in patients with antiphospholipid syndrome : a longitudinal cohort study
著者	Sato, T. ; Nakamura, H. ; Fujieda, Y. ; Ohnishi, N. ; Abe, N. ; Kono, M. ; Kato, M. ; Oku, K. ; Bohgaki, T. ; Amengual, O. ; Yasuda, S. ; Atsumi, T.
著者名 Sato, T.
著者名 Nakamura, H.
e-Rad_Researcher 70790872 著者名 Fujieda, Y.
著者名 Ohnishi, N.
著者名 Abe, N.
著者名 Kono, M.
著者名 Kato, M.
著者名 Oku, K.
著者名 Bohgaki, T.
著者名 Amengual, O.
著者名 Yasuda, S.
e-Rad_Researcher 20301905 著者名 Atsumi, T.
言語	英語
キーワード	Antiphospholipid syndrome
	factor Xa inhibitor
	hemorrhage
	thrombosis
	warfarin
発行日	2019-10-21
出版者	SAGE Publications
収録物名	Lupus
巻(号)	28(13)
ページ	1577-1582
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	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
PISSN	0961-2033
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1177/0961203319881200