Long-term direct oral anticoagulation in primary osteonecrosis with elevated plasminogen activation inhibitor

Haydock, Maria Monica; Elhamdani, Shahed; Alsharedi, Mohamed

doi:10.1177/2050313x19827747

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…The new generation of anticoagulants has many advantages: oral administration in fixed doses, stable effects, no need for routine monitoring, and few food/drug interactions. Case reports have already been published in which ONFH evolved favorably under different types of DOAC [75,110,111,116,117].…”

Section: Discussionmentioning

confidence: 99%

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Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

Rezuş

Tamba

Bădescu

et al. 2021

IJMS

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Osteonecrosis of the femoral head (ONFH) is a debilitating disease with major social and economic impacts. It frequently affects relatively young adults and has a predilection for rapid progression to femoral head collapse and end-stage hip arthritis. If not diagnosed and treated properly in the early stages, ONFH has devastating consequences and leads to mandatory total hip arthroplasty. The pathophysiology of non-traumatic ONFH is very complex and not fully understood. While multiple risk factors have been associated with secondary ONFH, there are still many cases in which a clear etiology cannot be established. Recognition of the prothrombotic state as part of the etiopathogeny of primary ONFH provides an opportunity for early medical intervention, with implications for both prophylaxis and therapy aimed at slowing or stopping the progression of the disease. Hereditary thrombophilia and hypofibrinolysis are associated with thrombotic occlusion of bone vessels. Anticoagulant treatment can change the natural course of the disease and improve patients’ quality of life. The present work focused on highlighting the association between hereditary thrombophilia/hypofibrinolysis states and ONFH, emphasizing the importance of identifying this condition. We have also provided strong arguments to support the efficiency and safety of anticoagulant treatment in the early stages of the disease, encouraging etiological diagnosis and prompt therapeutic intervention. In the era of direct oral anticoagulants, new therapeutic options have become available, enabling better long-term compliance.

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Section: Discussionmentioning

confidence: 99%

“…A case report of a 40-year-old Caucasian woman with osteonecrosis in the distal femur and homozygosity for the 4G variant in the PAI-1 gene was published by Haydock et al [116]. The patient received full anticoagulant treatment with enoxaparin, 1 mg/kg bid for 6 months, and experienced major relief of symptoms.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

Rezuş

Tamba

Bădescu

et al. 2021

IJMS

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show abstract

“…Moreover, most patients registered a resolution of pain and restoration of full function. Haydock et al published the case of a 40-year-old Caucasian woman with hypofibrinolysis (4G4G genotype of the PAI-1 gene) and osteonecrosis in the distal femur, in which the anticoagulant treatment led to the cessation of bone pain and prevented osteonecrosis progression [ 160 ].…”

Section: Treatment Of Hereditary Thrombophilia/hypofibrinolysismentioning

confidence: 99%

Osteonecrosis of the Jaws in Patients with Hereditary Thrombophilia/Hypofibrinolysis—From Pathophysiology to Therapeutic Implications

Bădescu

Rezuş

Ciocoiu

et al. 2022

IJMS

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Osteonecrosis of the jaws (ONJ) usually has a clear etiology. Local infection or trauma, radiotherapy and drugs that disrupt the vascular supply or bone turnover in the jaws are its major contributors. The thrombotic occlusion of the bone’s venous outflow that occurs in individuals with hereditary thrombophilia and/or hypofibrinolysis has a less known impact on jaw health and healing capability. Our research provides the most comprehensive, up-to-date and systematized information on the prevalence and significance of hereditary thrombophilia and/or hypofibrinolysis states in ONJ. We found that hereditary prothrombotic abnormalities are common in patients with ONJ refractory to conventional medical and dental treatments. Thrombophilia traits usually coexist with hypofibrinolysis traits. We also found that frequently acquired prothrombotic abnormalities coexist with hereditary ones and enhance their negative effect on the bone. Therefore, we recommend a personalized therapeutic approach that addresses, in particular, the modifiable risk factors of ONJ. Patients will have clear benefits, as they will be relieved of persistent pain and repeated dental procedures.

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Recent progress in the treatment of sickle cell disease: an up-to-date review

Acharya

Barik

Mohapatra³

et al. 2023

Beni-Suef Univ J Basic Appl Sci

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Background Sickle cell disease is a fatal systemic condition characterized by acute painful episodes, persistent anemia, ongoing organ damage, organ infarction, and a markedly shorter average lifetime. It first appeared in the tropics' malarial zones, where carriers benefit from an evolutionary advantage by being shielded from malaria death. Due to demographic shifts, this crisis now affects people all over the world. In higher-income areas, such as vast swaths of Europe and North and South America, more children are born with the syndrome. Main body Over the last 10 years, a clearer knowledge of the change from fetal to adult hemoglobin has evolved. Further investigation into chimerism, genomics, mixed gene editing, and therapeutic reactivation of fetal hemoglobin has produced very promising findings. Between 2017 and 2019, three innovative medications for sickle cell disease were approved by the FDA thanks to previous advances, while many more treatments are now under development. Short conclusion To improve patient outcomes, various innovative medications that were created in the late 1990s and utilized to treat sickle cell disease are examined in this study. In our appraisal, we'll also focus on the most important developments of the decade.

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Long-term direct oral anticoagulation in primary osteonecrosis with elevated plasminogen activation inhibitor

Cited by 5 publications

References 24 publications

Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

Osteonecrosis of the Jaws in Patients with Hereditary Thrombophilia/Hypofibrinolysis—From Pathophysiology to Therapeutic Implications

Recent progress in the treatment of sickle cell disease: an up-to-date review

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