Failure of Direct Oral Anticoagulants in Three Patients with Antiphospholipid Antibody Syndrome

Abstract

Antiphospholipid antibody syndrome is a clinical condition that is characterized by recurrent venous and/or arterial thrombosis, and/or pregnancy morbidity in patients who have positive antiphospholipid antibodies. Clinicians firstly aim to prevent recurrent thrombosis by long-term anticoagulation in these patients. Warfarin is the mainstay drug that is most commonly used in thrombotic antiphospholipid antibody syndrome. It’s narrow therapeutic window requires close regular monitoring of the International Normalized Ratio (INR), which is inconvenient and costly. In the past decade direct oral anticoagulants have been characterized. Today we do not know whether direct oral anticoagulants are safe and effective in comparison with warfarin in patients with antiphospholipid antibody syndrome. We report herein three patients with failure of thrombotic prevention during treatment with rivaroxaban and dabigatran.