Eur Rev Med Pharmacol Sci: A real-world study of edoxaban in the treatment of venous thromboembolism/pulmonary embolism in lupus anticoagulant-positive patients during the COVID-19 pandemic lockdown in Italy

According to the latest international guidelines, direct oral anticoagulants (DOACs) are recommended for the treatment and prevention of venous thromboembolism (VTE)

Antiphospholipid syndrome (APS) is characterized by an increased risk of arterial and venous thrombosis and the presence of autoimmune properties including lupus anticoagulant (LAC), anticardiolipin (anti-cl), and anti-β2 glycoprotein I antibody (aβ2GPI) ) positive

The recommended treatment for thromboembolic complications in APS is VKA, which may be related to antiplatelet drugs

In 2018, Pengo et al.

However, during the first phase of the Italian COVID-19 pandemic, many patients treated with VKA faced challenges in maintaining their original regimen due to the difficulty in assessing the international normalized ratio (INR) in a timely manner

research method

The study evaluated 31 Italian patients with unprovoked VTE and PE after warfarin therapy from March to June 2020 who were ineligible for VKA because of difficulty in measuring INR during the COVID-19 pandemic lockdown, He was switched to edoxaban (28 patients 60 mg/d; 3 patients 30 mg/d)

After treatment began, telemedicine visits were conducted every two months

Research result

One male withdrew from the study due to severe trauma requiring management of a left thigh hematoma

No recurrence of VTE/PE or arterial events occurred within 8-9 months of treatment with edoxaban

During the observation period, no significant changes in the levels of hemoglobin, platelets, creatinine, fibrinogen, D-dimer and other biochemical parameters were found (Table 1)

One male patient presented with progressive dyspnea, was diagnosed with lung cancer 20 days before the end of the observation period, and had no previous signs of PE or new VTE

Table 1.

Analysis conclusion

Edoxaban is safe and effective for the prevention and treatment of VTE/PE recurrence in LAC-positive patients without arterial events

Original source:

Puccetti L, Sammartano V, Calzoni P, et al.