Apixaban Prophylactic Anticoagulation in Patients with Nephrotic Syndrome.

TH Open: Companion Journal to Thrombosis and Haemostasis Pub Date : 2022-10-07 eCollection Date: 2022-10-01 DOI:10.1055/a-1920-6224
Tess Van Meerhaeghe, Alexandre Cez, Karine Dahan, Emmanuel Esteve, Ismail Elalamy, Jean Jacques Boffa, Eleonore Ponlot
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引用次数: 2

Abstract

Background  Nephrotic syndrome (NS) is associated with an increased risk of thromboembolic events (TEs), due to hemostatic derangements. The use of direct oral anticoagulants (DOACs) in the prevention of TE has not been studied intensively in patients suffering from NS. Methods  The method included retrospective analysis of consecutive incident patients with NS due to glomerular disease, receiving apixaban for thromboprophylaxis. It is an uncontrolled, single-center study. Results  We identified 27 patients treated with apixaban for the prevention of TEs, in the context of NS. During follow-up, apixaban minimal blood concentration (trough level; Cmin) and maximum blood concentration (Cmax) levels were measured. The mean duration of the anticoagulant treatment was 153 days (±132). Patients were followed for a mean of 14.7 months (±8.4) since the introduction of apixaban. Three patients had a TE at the time of NS diagnosis. Two patients had pulmonary embolism (PE) and one patient presented a stroke in a lupus membranous nephropathy context. One patient developed PE approximately 2 months after the introduction of apixaban treatment. No minor or major bleeding events were noticed. Conclusion  The present study shows that patients, suffering from severe NS under anticoagulant therapy with apixaban had a reduced risk of venous and arterial TEs compared with patients previously described in the literature, without increased risk of bleeding.

Abstract Image

Abstract Image

阿哌沙班在肾病综合征患者中的预防性抗凝作用。
背景:由于止血功能紊乱,肾病综合征(NS)与血栓栓塞事件(TEs)的风险增加有关。直接口服抗凝剂(DOACs)在NS患者中预防TE的应用尚未得到深入研究。方法回顾性分析连续接受阿哌沙班治疗的肾小球疾病致NS患者。这是一项不受控制的单中心研究。结果我们确定了27例接受阿哌沙班治疗的患者,以预防NS背景下的TEs。随访期间,阿哌沙班最低血药浓度(谷值;测量Cmin)和最大血药浓度(Cmax)水平。抗凝治疗的平均持续时间为153天(±132天)。自引入阿哌沙班以来,患者平均随访14.7个月(±8.4)。3例患者在NS诊断时有TE。两名患者有肺栓塞(PE),一名患者在狼疮膜性肾病背景下出现中风。1例患者在引入阿哌沙班治疗约2个月后发生PE。没有发现轻微或严重的出血事件。结论本研究表明,重症NS患者在阿哌沙班抗凝治疗下发生静脉和动脉TEs的风险较文献中先前描述的患者降低,且出血风险未增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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