Successful treatment with rivaroxaban of an extended superficial vein thrombosis in a patient with acquired antithrombin deficiency due to Peg-asparaginase treatment

Plander, Márk; Szendrei, Tamás; Bodó, Imre; Ivanyi, J

doi:10.1007/s00277-015-2368-1

Cited by 17 publications

(9 citation statements)

References 8 publications

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“…In the present case, a 90-year-old woman with AT deficiency was successfully and safely managed using rivaroxaban to prevent thromboembolism during the perioperative period. While a few reports have described the use of rivaroxaban to treat AT deficiency ( 8 - 10 ), none have reported the outcome in a very elderly patient, such as in the present case.…”

Section: Discussionmentioning

confidence: 64%

The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period

et al. 2017

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Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture. The present case illustrates the effectiveness of rivaroxaban in preventing thromboembolisms due to surgery, even in very elderly patients with antithrombin deficiency. Further investigations are needed to determine the optimal dosage of rivaroxaban.

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Section: Discussionmentioning

confidence: 64%

The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period

et al. 2017

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“…Most experience with anticoagulation for the treatment of acute VTE attributed to asparaginase during ALL treatment is with LMWH . There are several case reports describing the successful use of direct oral anticoagulants (DOAC) in the setting of asparaginase‐associated VTE . In the Hokusai Cancer VTE study, edoxaban was effective for treatment of acute VTE in cancer patients but carried an increased risk of hemorrhage .…”

Section: Management Of Vte During Asparaginase Therapymentioning

confidence: 99%

The prevention and management of asparaginase‐related venous thromboembolism in adults: Guidance from the SSC on Hemostasis and Malignancy of the ISTH

Zwicker

Wang

DeAngelo

et al. 2020

Journal of Thrombosis and Haemostasis

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Venous thromboembolism is a common complication of asparaginase-based chemotherapy regimens for the treatment of acute lymphoblastic leukemia. Thrombosis associated with asparaginase administration poses a number of specific and often clinically challenging management decisions. This review provides guidance on the prevention and treatment of thrombosis associated with asparaginase in adults including discussions on antithrombin repletion, pharmacologic thromboprophylaxis, cerebral venous thrombosis, and therapeutic anticoagulation. K E Y W O R D S acute lymphoblastic leukemia, anticoagulation, antithrombin, asparaginase, cerebral venous thrombosis, venous thromboembolism The guidance statements included in this document are similar to those in other guidance documents and are predicated on the following premises: For each of the clinical situations, our guidance statements are applicable to an average adult patient with venous thromboembolism (VTE) associated with asparaginase therapy during the course of therapy for acute lymphoblastic leukemia (ALL).We anticipate that there will be clinical circumstances for which our guidance statements do not apply. As for all cases, our statements may provide guidance but do not replace clinical judgement for the management of individual patients.• The wording "we recommend" reflects a strong guidance statement with strong consensus among the authors, whereby the clinician should consider adopting the practice in a majority of cases.

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“…Several case series have described successful resolution of thrombus and prevention of recurrent VTE with rivaroxaban, dabigatran, apixaban, and edoxaban in patients with major hereditary thrombophilia. 32-34 Furthermore, both rivaroxaban and dabigatran have been used to successfully reverse skin necrosis caused by warfarin in 2 patients with severe protein C and S deficiency. 35,36 Several case series have emerged describing DOACs in these patients.…”

Section: Data Synthesismentioning

confidence: 99%

Direct Oral Anticoagulants in Select Patients With Hypercoagulable Disorders

Valanejad

Davis

2020

Ann Pharmacother

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Objective: To summarize the literature assessing the safety and efficacy of direct oral anticoagulants (DOACs) for the acute treatment and secondary prevention of venous thromboembolism (VTE) in select patients with hypercoagulable disorders. Data Sources: An electronic PubMed literature search was conducted from January 2010 to July 2020 using the following keywords: DOAC, rivaroxaban, apixaban, dabigatran, edoxaban, thrombophilia, cancer, antiphospholipid syndrome, protein C deficiency, protein S deficiency, antithrombin deficiency, factor V Leiden, prothrombin G20210A gene mutation, congenital thrombophilia, hypercoagulable, hereditary thrombophilia, acquired thrombophilia. Study Selection and Data Extraction: Articles were included if they reported clinical outcomes associated with cancer-associated VTE, antiphospholipid syndrome (APS), and other hereditary thrombophilias. Data Synthesis: The safety and efficacy of using a DOAC is highly dependent on the type of hypercoagulable disease state. Current trials support the use of edoxaban, rivaroxaban, and apixaban for the treatment of cancer-associated thrombosis (CAT), with apixaban being preferred because of lower bleeding rates compared with standard of care. The use of DOACs, especially rivaroxaban, have been associated with worse outcomes in patients with APS, whereas data on DOAC use in hereditary thrombophilia remains scarce and limited to low-risk patients. Relevance to Patient Care and Clinical Practice: This review evaluates the literature assessing the safety and efficacy of DOACs in patients with various hypercoagulable disorders. Conclusions: The current body of evidence supports the use of select DOACs for the treatment of CAT. In contrast, DOAC use in patients with APS and hereditary thrombophilia should be avoided at this time.

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Successful treatment with rivaroxaban of an extended superficial vein thrombosis in a patient with acquired antithrombin deficiency due to Peg-asparaginase treatment

Cited by 17 publications

References 8 publications

The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period

The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period

The prevention and management of asparaginase‐related venous thromboembolism in adults: Guidance from the SSC on Hemostasis and Malignancy of the ISTH

Direct Oral Anticoagulants in Select Patients With Hypercoagulable Disorders

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