Lupus & antiphospholipid syndrome
Direct oral anticoagulants versus Vitamin K antagonists in antiphospholipid syndrome: A systematic review and meta-analysis
Pooled result · Composite of ATE and VTEResult — go to the resultIncidence rate ratio 2.33 95 % CI 1.18–4.58Authors' conclusion
In patients with thrombotic APS, the use of DOACs is associated with increased thrombotic events compared with VKAs, mainly driven by arterial thrombotic events.
Study context
- Population
- Patients with thrombotic antiphospholipid syndrome (APS)12 studies (4 randomized controlled trials (RCTs), 8 observational)
- Participants
- 1,307 patients
- Comparison
- Direct oral anticoagulants (DOACs) vs Vitamin K antagonists (VKAs)
- Outcome
- Composite of:
- Arterial (ATE)
- Venous thrombotic events (VTE)
Methodological detailsGRADE certainty of evidence, incidence rate ratios
- GRADE certainty of evidence
- Incidence rate ratios
Pooled result
Composite of:
Incidence rate ratio
2.33
95 % CI 1.18–4.58
DOACsvs VKAs
IRR 2.33 (95 % CI 1.18–4.58)
As reported in the abstract
Further pooled results
| Outcome | IRR (95 % CI) | |
|---|---|---|
| Arterial thrombotic events (ATE)GRADE=low · increased ATE drove the increase in the primary endpoint | 2.70 (1.42–5.13) | |
| MIGRADE=very low | 4.71 (1.00–22.21) | |
| StrokeGRADE=very low | 7.48 (1.27–44.13) | |
| 0.050.21520Incidence rate ratio (log scale) |
- Arterial thrombotic events (arterial (ATE)): increased risk consistently observed in a dedicated analysis of RCTs; mitigated by concomitant single antiplatelet therapy
Venous thrombotic events (VTE)
- VTE did not differ significantly between groups (IRR)
- 0.98; 95 % CI 0.59-1.64
- GRADE=low
Safety
Major bleeding
- Major bleeding did not differ significantly between groups (IRR)
- 0.83; 95 % CI 0.48-1.43
- GRADE=low
Non-major bleeding
- Non-major bleeding did not differ significantly between groups (IRR)
- 1.32; 95 % CI 0.81-2.14
- GRADE=very low
Original publication
Direct oral anticoagulants versus Vitamin K antagonists in antiphospholipid syndrome: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 1 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →