Edoxaban improves acute venous thromboembolism while preserving protein C and protein S levels

Yamazaki, Harutake; Yagi, Shusuke; Torii, Yasuhiro; Amano, Rie; Oomichi, Yasuyuki; Sangawa, Teruaki; Fukuda, Daiju; Kadota, Muneyuki; Ise, Takayuki; Ueno, Rie; Hara, Tomoya; Kusunose, Kenya; Matsuura, Tomomi; Tobiume, Takeshi; Yamaguchi, Koji; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Akiyama, Masashi; Sata, Masataka

doi:10.1016/j.jjcc.2017.09.009

Cited by 6 publications

(4 citation statements)

References 18 publications

(12 reference statements)

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“…Ameku et al recently reported a patient with protein S deficiency and recurrent venous thromboembolism (VTE) under treatment with warfarin who was effectively treated with rivaroxaban [ 15 ]. A study of 57 patients with acute VTE showed that edoxaban may have more therapeutic benefit than warfarin in VTE patients with or without pulmonary embolism, as it preserves protein C and protein S levels [ 16 ]. Another recently published case report showed that apixaban may be an alternative treatment to VKA for the secondary prevention of ischemic stroke in a patient with protein S deficiency [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report

2021

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Protein S deficiency is a thrombophilia associated with an increased risk of thromboembolism. Previous studies have shown its role as a predisposing factor for venous thromboembolism, but its role in recurrent arterial ischemic stroke remains uncertain. Here we report a patient with recurrent ischemic stroke due to protein S deficiency. Oral anticoagulant treatment with vitamin K antagonist (VKA) drugs is used to treat and prevent thromboembolic events caused by thrombophilia, but it has many limitations, especially in the case of recurrent thromboembolic events. Direct oral anticoagulants (DOACs) have many advantages over VKA. Previous studies have shown that they are safe in cases of thrombophilia, but they are not well studied in recurrent ischemic stroke due to protein S deficiency. In this study our patient was treated with rivaroxaban. Protein S deficiency may be a predisposing factor in recurrent ischemic stroke, and rivaroxaban can be a safe and effective treatment option. Further studies are needed to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report

2021

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“…Thus, further inhibition of PS could be worsen VTE in patients with PS deficiency. We previously showed that warfarin therapy decreased PS activity to 46% and PC activity to 62%, but that edoxaban therapy maintained PS and PC activity to 90% and 93%, respectively, in patients with VTE (14). Thus, DOACs could be preferable therapy for VTE in patients with PS/PC deficiency.…”

Section: Discussionmentioning

confidence: 97%

Recurrent venous thrombosis during direct oral anticoagulant therapy in a patient with protein S deficiency

et al. 2019

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“…Namun, meskipun warfarin telah sering digunakan sebagai terapi antikoagulan, warfarin dapat menekan aktivitas protein S sehingga memperburuk kondisi defisiensi protein S (Ohashi et al, 2020). Oleh karena itu penggunaan DOACs jauh lebih dianjurkan dari segi efikasi maupun keamanan pada kondisi pasien defisiensi protein S (Yamazaki et al, 2018). Manfaat lain dari DOAC adalah memiliki dosis yang pasti, interaksi obat yang terbatas, dan potensial untuk membalikkan aktivitas antikoagulan (Majumder & Nguyen, 2021).…”

Section: Manajemen Defisiensi Protein Sunclassified

Protein S Defficiency and The Mechanism of Protein S in Hemostasis and Atherosclerosis

Agistany,

Ramadhan,

Rizki

et al. 2023

JBT

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Protein S (PS) is Vitamin K dependant protein which plays a role in regulating the blood clotting process in the body. Protein S deficiency is explained as a condition characterized by reduced levels of protein S in the serum so that it makes the blood clot too easily. The purpose of this literature review is to give an update of protein S defficiency and the mechanism of protein s in hemostasis and atherosclerosis based on publish literature reference from various database. Protein S plays important role in hemostasis by regulating blood cloth process in the initiation phase of the extrinsic pathway as a TFPI cofactor or in the propagation phase, namely as an APC cofactor and independent activity of TFPIα and APC. Protein S deficiency is known to be associated with the occurrence of atherosclerosis via the Tyro3-Axl-Mer (TAM) receptor. The main clinical manifestations of the majority of patients with heterozygous mutations in the protein S (PROS1) gene are deep vein thrombosis (DVT) and pulmonary embolism that precipitate by VTE. Administration of anticoagulant drugs such as heparin in the form of low-molecular-weight heparin (LMWH) or unfractionated heparin, vitamin K antagonists (VKA), namely warfarin, or direct oral anticoagulants (DOACs) can be selected as a management of protein S deficiency with VTE. Protein S has a central role in the coagulation prosses and its deficiency associated with atherosclerotic conditions.

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Edoxaban improves acute venous thromboembolism while preserving protein C and protein S levels

Abstract: Edoxaban improves VTE while preserving protein C and protein S levels, thereby indicating that edoxaban improves thrombotic burden while maintaining levels of anticoagulants.

Cited by 6 publications

References 18 publications

Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report

Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report

Recurrent venous thrombosis during direct oral anticoagulant therapy in a patient with protein S deficiency

Protein S Defficiency and The Mechanism of Protein S in Hemostasis and Atherosclerosis

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