Lupus & antiphospholipid syndrome
Therapy with direct oral anticoagulants for secondary prevention of thromboembolic events in the antiphospholipid syndrome: a systematic review and meta-analysis of randomised trials
Pooled result · New thrombotic events (any venous or arterial thrombosis)Result — go to the resultPeto OR 3.01 95% CI 1.56–5.78Authors' conclusion
DOACs were associated with a significant increase in the risk of a new thrombotic event, especially AT, favouring standard prophylaxis with warfarin.
Study context
- Population
- Individuals >18 years with antiphospholipid syndrome (APS) classified according to the criteria valid when the trial was carried out
- Participants
- 624 individuals5 randomised trials
- Comparison
- Direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs) for secondary prevention of thromboembolic events in APS
- Outcome
- New thrombotic events, a composite of any venous or arterial thrombosis, during the VKA-controlled phase of treatment
Methodological detailsPeto method
- Peto method
Pooled result
As reported in the abstract
New thrombotic events:
- Any venous
- Arterial thrombosis
Peto OR
3.01
95% CI 1.56–5.78
P = 0.001
Events by group
DOAC
29
events
VKA
10
events
DOACvs VKA
Peto OR 3.01 (95% CI 1.56–5.78); P = 0.001
Further pooled results
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Arterial thrombosisDOACvs VKA | 5.5 (2.5–12.1) | P < 0.0001 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Venous thrombosisDOAC vs VKA | P = 0.87 |
Venous thrombosis
- No difference in risk of venous thrombosis (VT)
Safety
- No significant difference in risk of bleeding
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Therapy with direct oral anticoagulants for secondary prevention of thromboembolic events in the antiphospholipid syndrome: a systematic review and meta-analysis of randomised trials. Lupus Sci Med. Published 29 October 2023. doi:10.
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