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Non-vitamin K antagonist oral anticoagulants and antiphospholipid syndrome

机译：非维生素K拮抗剂口腔抗凝血剂和抗磷脂综合征

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摘要

The current treatment of thrombotic APS patients includes long-term anticoagulation with oral vitamin K antagonists (VKAs), with warfarin being the one most commonly used. However, the use of VKAs can be challenging, especially in patients with APS. VKAs monitoring in patients with aPL is complicated by the heterogeneous responsiveness to LAs of reagents used in the International Normalized Ratio test, potentially resulting in instability of anticoagulation. For decades, VKAs were the only available oral anticoagulants. However, non-VKA oral anticoagulants, including a direct thrombin inhibitor (dabigatran etexilate) and direct anti-Xa inhibitors (rivaroxaban, apixaban and edoxaban), are currently available. The use of these agents may represent a major step forward since, unlike VKAs, they have few reported drug interactions and they do not interact with food or alcohol intake, thereby resulting in more stable anticoagulant intensity. Most importantly, monitoring their anticoagulant intensity is not routinely required due to their predictable anticoagulant effects. In this review, we discuss the clinical and laboratory aspects of non-VKA oral anticoagulants, focusing on the available evidence regarding their use in patients with APS.
机译：目前对血栓形成APS患者的治疗包括用口服维生素K拮抗剂（VKAS）的长期抗凝，Warfarin是最常用的。然而，使用VKAS可能是挑战性的，特别是在AP的患者中。 VKAS监测APL患者对国际标准化比率试验中使用的试剂的非均相反应性，可能导致抗凝的稳定性。几十年来，VKA是唯一可用的口服抗凝剂。然而，目前可获得具有直接凝血酶抑制剂（Dabigatran eXexilate）和直接抗XA抑制剂（罗昔滨，甲烷类和Edoxaban）的非VKA口腔抗凝血剂。这些试剂的使用可以代表前进的重大步骤，因为与VKAs不同，它们据报道的药物相互作用很少，并且它们不会与食物或酒精摄入相互作用，从而导致更稳定的抗凝血强度。最重要的是，由于其可预测的抗凝血效果，监测它们的抗凝血强度并不常规。在本综述中，我们讨论了非VKA口服抗凝血剂的临床和实验室方面，重点是有关AP患者使用的可用证据。

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