Apixaban and rivaroxaban in patients with cerebral venous thrombosis

Covut, Fahrettin; Kewan, Tariq; Pérez, Óscar; Flores, Monica Velasquez; Haddad, Abdo; Daw, Hamed

doi:10.1016/j.thromres.2018.11.018

Cited by 32 publications

(40 citation statements)

References 12 publications

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“…The main studies evaluating the use of the DOACs in patients with CVT are summarized in Table 1. They were mainly small observational studies, either retrospective [36][37][38][39][40] or prospective [41][42][43], and there was only one RCT [44]. The number of patients treated with DOAC ranged from 6 [38] to 60 [44] patients.…”

Section: Treatmentmentioning

confidence: 99%

“…The number of patients treated with DOAC ranged from 6 [38] to 60 [44] patients. The average anticoagulant treatment duration ranged from 5 [44] to 12 [40] months. Three studies evaluated rivaroxaban [36,38,41], two dabigatran [37,44], and three cohorts included different DOACs [40,42,43].…”

Section: Treatmentmentioning

confidence: 99%

“…Three studies evaluated rivaroxaban [36,38,41], two dabigatran [37,44], and three cohorts included different DOACs [40,42,43]. In the majority of the studies, the DOAC were used after an initial treatment with UFH or LMWH [36,37,40,42,44] in order to achieve stable conditions. There was only one study enrolling 20 patients who started directly with rivaroxaban 15 mg twice daily (BID) for 3 weeks, followed by 20 mg once daily (OD) [41].…”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Riva

Ageno

2020

JCM

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Cerebral vein thrombosis (CVT) and splanchnic vein thrombosis (SVT) are two manifestations of venous thromboembolism (VTE) at unusual sites. They have an incidence at least 25–50 times lower than usual site VTE, but represent true clinical challenges. Recent evidence on the epidemiology, risk factors, prognosis, and treatment of CVT and SVT has been published in the last two decades, thus contributing to a better understanding of these diseases. The improvement in imaging techniques and a higher degree of clinical suspicion may have led to the observed increased frequency, whereas a better knowledge of provoking mechanisms could have contributed to reducing the proportion of events classified as unprovoked or idiopathic (13–21% of CVT, 15–27% of SVT). Few small randomized clinical trials and a number of observational studies, although hampered by heterogeneous therapeutic approaches, shed light on the safety and effectiveness of anticoagulant therapy in these populations. However, there are still some grey areas that warrant future research. In this narrative review, we discuss recent advances and therapeutic challenges in CVT and SVT.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Riva

Ageno

2020

JCM

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“…However, evidence on the use of DOACs in these special circumstances is still relatively weak. Critical studies are underway (58), and first line drugs are LMWH and warfarin. Use of DOACs is likely to increase along with new evidence as it is gained.…”

Section: Oral Anticoagulation In Cardiologymentioning

confidence: 99%

Clinical use and laboratory testing of oral anticoagulation therapy: experience from Finland

Helin

Joutsi‐Korhonen²,

Lassila³

2019

Ann. Blood

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Anticoagulation therapy has been undergoing a transition during the last decade with the progressive availability of direct oral anticoagulants (DOACs). While DOACs are increasingly used in common indications for anticoagulation, including non-valvular atrial fibrillation (AF), deep vein thrombosis (DVT) and pulmonary embolism (PE), traditional anticoagulants, either warfarin or heparins, remain the primary choice for patients with cardiac valvular replacement, severe thrombophilia, pediatric, pregnant and many cancer patients. Laboratory monitoring of warfarin and heparins are well established, while under specific emergency conditions DOACs require specific assays, the availability of which may be limited.Finland benefits from centralized laboratory networks, offering harmonized services throughout our rather sparsely populated country. Specific assays for all DOACs are available 24/7 in the core laboratory (Southern Finland). Interaction, collaboration and continuous education between clinic and laboratory is increasingly needed, under the era of rapid change of traditions in anticoagulation management.

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“…None of the nine patients treated with rivaroxaban or apixaban were found to have repeat thrombotic events after 12-month follow-up, and none had clinically significant bleeding. 19 While promising, significant studies of DOACs in the setting of CVT are necessary to investigate potential roles for this class of medication. Currently, there are several upcoming trials comparing standard warfarin to DOACs, the most prominent being a phase 3 trial called RE-SPECT CVT comparing dabigatran to warfarin for its efficacy in treating CVT, which has reached its primary completion date as of June 2018, and results are pending although preliminarily data suggest that dabigatran is generally as safe as Coumadin.…”

Section: Role Of Direct Oral Anticoagulantsmentioning

confidence: 99%

Cerebral Venous Thrombosis: Reviewing Pathophysiology, Diagnosis, and Treatment Strategies

O'Keefe

Kranz

Dombrowski

et al. 2019

Journal of Neuroanaesthesiology and Critical Care

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This review discusses cerebral venous thrombosis (CVT), including diagnosis and treatment strategies, a rare class of stroke that, if unrecognized or untreated, can have devastating effects. Thrombosis of one or many cerebral veins leads to propagation of thrombosis and impaired cerebral venous drainage. Diagnosis is made using a combination of history and imaging, particularly computed tomography (CT) venogram, which demonstrates thrombosis. Currently, acute treatment consists of heparin infusion with transition to long-term oral anticoagulation. Further research, especially on prevention, endovascular therapy, and the role of newer anticoagulants (direct oral anticoagulants [DOACs]) is necessary and ongoing. AbstractKeywords ► cerebral venous thrombosis ► anticoagulation ► venous hemorrhage

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Apixaban and rivaroxaban in patients with cerebral venous thrombosis

Cited by 32 publications

References 12 publications

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Clinical use and laboratory testing of oral anticoagulation therapy: experience from Finland

Cerebral Venous Thrombosis: Reviewing Pathophysiology, Diagnosis, and Treatment Strategies

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