ANTICOAGULANT TREATMENT WITH APIXABAN IN INHERITED ANTITHROMBIN DEFICIENCY
(Abstract release date: 05/19/16)
EHA Library. Calzadilla K. 06/09/16; 135114; PB2214
Dr. Karla Susana Calzadilla
Contributions
Contributions
Abstract
Abstract: PB2214
Type: Publication Only
Background
Apixaban, a direct inhibitor of activated factor X, has at least the same efficacy and safety as vitamin K antagonists (VKA) for secundary prevention of recurrent venous thrombosis in adults, but no data in patients with inherited Antithrombin Deficiency are available.
Aims
Evaluate apixaban as a valid anticoagulation alternative in adults patients with inherited Antithrombin Deficiency and difficulty for treatment with VKA
Methods
We report a case of a 49-year-old man with Crohn disease, on long-term anticoagulation with low molecular weight heparin (LMWH) by recurrent episodes of venous thrombosis due to inherited Antithrombin Deficiency. Due with the difficulty for treatment with VKA because his severe Crohn disease, it was decided to maintain anticoagulation with intermedie doses of LMWH (therapeutic doses were associated with rectal bleeding). To obviate LMWH-associated osteoporosis, the use of calcium and vitamin D supplementation, and weight-bearing exercise were recommended. Proximal femur bone and lumbar spine density measurements were taken at baseline and each 6 months. Two years later, significant osteopenia was observed at the proximal femur bone, so heparin was replaced by 2.5 mg/12 h apixaban. Nine months later, he has not suffered thrombotic recurrence neither bleeding complications, but there were not any changes in bone densitometry.
Results
This is the first description of the use of apixaban in secundary prevention of recurrent venous thrombosis induced by Inherited Antithrombin Deficiency. Our patient on long-term anticoagulation with apixaban has not experienced bleeding or thrombotic complications months after transitioning to apixaban, but osteopenia has stayed without changes.
Conclusion
We believe that apixaban may be considered as a valid anticoagulant alternative in adults with inherited Antithrombin Deficiency and difficulty for treatment with VKA, although until results of prospective randomised trials are available, we recommend caution in using apixaban in patients with inherited thrombophilia. However, LMWH-associated osteopenia does not seem to improve after transitioning to apixaban
Session topic: E-poster
Keyword(s): Anticoagulants, Antithrombin, Heparin, Thrombophilia
Type: Publication Only
Background
Apixaban, a direct inhibitor of activated factor X, has at least the same efficacy and safety as vitamin K antagonists (VKA) for secundary prevention of recurrent venous thrombosis in adults, but no data in patients with inherited Antithrombin Deficiency are available.
Aims
Evaluate apixaban as a valid anticoagulation alternative in adults patients with inherited Antithrombin Deficiency and difficulty for treatment with VKA
Methods
We report a case of a 49-year-old man with Crohn disease, on long-term anticoagulation with low molecular weight heparin (LMWH) by recurrent episodes of venous thrombosis due to inherited Antithrombin Deficiency. Due with the difficulty for treatment with VKA because his severe Crohn disease, it was decided to maintain anticoagulation with intermedie doses of LMWH (therapeutic doses were associated with rectal bleeding). To obviate LMWH-associated osteoporosis, the use of calcium and vitamin D supplementation, and weight-bearing exercise were recommended. Proximal femur bone and lumbar spine density measurements were taken at baseline and each 6 months. Two years later, significant osteopenia was observed at the proximal femur bone, so heparin was replaced by 2.5 mg/12 h apixaban. Nine months later, he has not suffered thrombotic recurrence neither bleeding complications, but there were not any changes in bone densitometry.
Results
This is the first description of the use of apixaban in secundary prevention of recurrent venous thrombosis induced by Inherited Antithrombin Deficiency. Our patient on long-term anticoagulation with apixaban has not experienced bleeding or thrombotic complications months after transitioning to apixaban, but osteopenia has stayed without changes.
Conclusion
We believe that apixaban may be considered as a valid anticoagulant alternative in adults with inherited Antithrombin Deficiency and difficulty for treatment with VKA, although until results of prospective randomised trials are available, we recommend caution in using apixaban in patients with inherited thrombophilia. However, LMWH-associated osteopenia does not seem to improve after transitioning to apixaban
Session topic: E-poster
Keyword(s): Anticoagulants, Antithrombin, Heparin, Thrombophilia
Abstract: PB2214
Type: Publication Only
Background
Apixaban, a direct inhibitor of activated factor X, has at least the same efficacy and safety as vitamin K antagonists (VKA) for secundary prevention of recurrent venous thrombosis in adults, but no data in patients with inherited Antithrombin Deficiency are available.
Aims
Evaluate apixaban as a valid anticoagulation alternative in adults patients with inherited Antithrombin Deficiency and difficulty for treatment with VKA
Methods
We report a case of a 49-year-old man with Crohn disease, on long-term anticoagulation with low molecular weight heparin (LMWH) by recurrent episodes of venous thrombosis due to inherited Antithrombin Deficiency. Due with the difficulty for treatment with VKA because his severe Crohn disease, it was decided to maintain anticoagulation with intermedie doses of LMWH (therapeutic doses were associated with rectal bleeding). To obviate LMWH-associated osteoporosis, the use of calcium and vitamin D supplementation, and weight-bearing exercise were recommended. Proximal femur bone and lumbar spine density measurements were taken at baseline and each 6 months. Two years later, significant osteopenia was observed at the proximal femur bone, so heparin was replaced by 2.5 mg/12 h apixaban. Nine months later, he has not suffered thrombotic recurrence neither bleeding complications, but there were not any changes in bone densitometry.
Results
This is the first description of the use of apixaban in secundary prevention of recurrent venous thrombosis induced by Inherited Antithrombin Deficiency. Our patient on long-term anticoagulation with apixaban has not experienced bleeding or thrombotic complications months after transitioning to apixaban, but osteopenia has stayed without changes.
Conclusion
We believe that apixaban may be considered as a valid anticoagulant alternative in adults with inherited Antithrombin Deficiency and difficulty for treatment with VKA, although until results of prospective randomised trials are available, we recommend caution in using apixaban in patients with inherited thrombophilia. However, LMWH-associated osteopenia does not seem to improve after transitioning to apixaban
Session topic: E-poster
Keyword(s): Anticoagulants, Antithrombin, Heparin, Thrombophilia
Type: Publication Only
Background
Apixaban, a direct inhibitor of activated factor X, has at least the same efficacy and safety as vitamin K antagonists (VKA) for secundary prevention of recurrent venous thrombosis in adults, but no data in patients with inherited Antithrombin Deficiency are available.
Aims
Evaluate apixaban as a valid anticoagulation alternative in adults patients with inherited Antithrombin Deficiency and difficulty for treatment with VKA
Methods
We report a case of a 49-year-old man with Crohn disease, on long-term anticoagulation with low molecular weight heparin (LMWH) by recurrent episodes of venous thrombosis due to inherited Antithrombin Deficiency. Due with the difficulty for treatment with VKA because his severe Crohn disease, it was decided to maintain anticoagulation with intermedie doses of LMWH (therapeutic doses were associated with rectal bleeding). To obviate LMWH-associated osteoporosis, the use of calcium and vitamin D supplementation, and weight-bearing exercise were recommended. Proximal femur bone and lumbar spine density measurements were taken at baseline and each 6 months. Two years later, significant osteopenia was observed at the proximal femur bone, so heparin was replaced by 2.5 mg/12 h apixaban. Nine months later, he has not suffered thrombotic recurrence neither bleeding complications, but there were not any changes in bone densitometry.
Results
This is the first description of the use of apixaban in secundary prevention of recurrent venous thrombosis induced by Inherited Antithrombin Deficiency. Our patient on long-term anticoagulation with apixaban has not experienced bleeding or thrombotic complications months after transitioning to apixaban, but osteopenia has stayed without changes.
Conclusion
We believe that apixaban may be considered as a valid anticoagulant alternative in adults with inherited Antithrombin Deficiency and difficulty for treatment with VKA, although until results of prospective randomised trials are available, we recommend caution in using apixaban in patients with inherited thrombophilia. However, LMWH-associated osteopenia does not seem to improve after transitioning to apixaban
Session topic: E-poster
Keyword(s): Anticoagulants, Antithrombin, Heparin, Thrombophilia
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