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. 2019 Jul 1;11(1):e2019044.
doi: 10.4084/MJHID.2019.044. eCollection 2019.

Direct Oral Anticoagulants in Patients Affected by Major Congenital Thrombophilia

Alessandra Serrao  1 , Benedetta Lucani  1 , Davide Mansour  1 , Antonietta Ferretti  1 , Erminia Baldacci  1 , Cristina Santoro  1 , Robin Foà  1 , Antonio Chistolini  1
Affiliations

Direct Oral Anticoagulants in Patients Affected by Major Congenital Thrombophilia

Alessandra Serrao et al. Mediterr J Hematol Infect Dis. .

Abstract

Background: Thrombophilia is a condition that predisposes to a higher incidence of venous thromboembolisms (VTE), some also in atypical sites. Direct oral anticoagulants (DOACs) have proven to be effective in the treatment of deep vein thrombosis (DVT). However, their use can be sometimes challenging in particular settings of patients such as those with major thrombophilia - antithrombin, protein C and protein S deficiency, homozygous mutation of Factor V Leiden, homozygous mutation of Factor II G20210A, combined heterozygous mutation of factor V Leiden and Factor II G20210A - carrying a high thrombotic risk.

Patients and methods: At our Center, 45 patients with major thrombophilia were treated with DOACs: 33 after an initial treatment with vitamin K antagonists (VKA) and 12 as first-line therapy for VTE. The median follow-up of DOACs treatment was 29 months.

Conclusions: No patient presented hemorrhagic or thrombotic complications during DOAC therapy. DOACs have proven to be effective and safe in this real-life series of patients with major thrombophilia.

Keywords: Antithrombin-III; Direct oral anticoagulant; Familial thrombophilia; Protein C and S deficiency; Vitamin K antagonist.

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Conflict of interest statement

Competing interests: The authors have declared that no competing interests exist.

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