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DOAK therapy in patients with antiphospholipid syndrome is not recommended
Several pharmaceutical companies point out that the use of certain blood thinners is not recommended in some patients because it may increase the risk of thrombosis.
Reduce the risk of cardiovascular diseases
“Anticoagulants are used to lower the risk of cardiovascular diseases caused by blood clots. This includes heart attacks, strokes and venous thrombosis ”, explains the Institute for Quality and Efficiency in Health Care (IQWiG) on the portal“ gesundheitsinformation.de ”. The drugs are colloquially referred to as "blood thinners", but according to the experts, this name is not entirely correct because they do not make the blood more fluid. The anticoagulant agents are divided into different groups. Not all are equally recommended for all patients.
Not suitable for all patients
Oral anticoagulants are particularly common. These inhibit the formation or action of certain coagulation factors.
"This group of drugs includes vitamin K antagonists (coumarins) such as the active ingredient phenprocoumon (known to many people under the trade name" Marcumar ") and so-called direct oral anticoagulants (DOAKs)," explains the IQWiG.
Oral anticoagulants are mainly used to treat atrial fibrillation, after the insertion of artificial heart valves or after pulmonary embolism.
However, treatment with such medications is not suitable for some patients, reports the Federal Institute for Drugs and Medical Devices (BfArM).
Increased risk of recurrent thrombotic events
As the institute writes in a Red Hand letter, use with apixaban (Eliquis), dabigatranetexilate (Pradaxa), edoxaban (Lixiana / Roteas), and rivaroxaban (Xarelto) in patients with antiphospholipid syndrome is due to a potentially increased risk of recurrent thrombotic events not recommended.
The pharmaceutical companies Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb / Pfizer EEIG and Daiichi Sankyo Europe provide information in coordination with the European Medicines Agency (EMA) and the BfArM.
A multicentre study found that rivaroxaban use was associated with an increased risk of recurrent thrombotic events in patients with a history of thrombosis diagnosed with antiphospholipid syndrome (APS) compared to warfarin.
Other DOAKs (apixaban, edoxaban and dabigatranetexilate) may also increase the risk of recurrent thrombosis compared to vitamin K antagonists such as warfarin or phenprocoumon.
The use of DOAK is therefore not recommended, especially in high-risk patients with APS. (ad)