Simaan Naaem, Metanis Issa, Honig Asaf, Hallevi Hen, Filioglo Andrei, Mendel Rom, Barnea Rani, Naftali Jonathan, Auriel Eitan, Aladdin Shorooq, Orion David, Dally Najib, Leker Ronen R, Molad Jeremy
Department of Neurology, Ziv Medical Center, Safed, Israel.
The Azrieli Faculty of Medicine, Safed Bar Ilan University, Safed, Israel.
Front Neurol. 2024 May 16;15:1404099. doi: 10.3389/fneur.2024.1404099. eCollection 2024.
Information regarding the safety and efficacy of specific direct oral anticoagulants (DOAC) in the treatment of cerebral sinus and venous thrombosis (CSVT) is scarce. Apixaban is one of the most frequently prescribed DOACs. Therefore, we aimed to compare the safety and efficacy of Apixaban with those of vitamin k antagonists (VKA) in patients with CSVT.
Prospective CSVT databases from seven academic medical centers were retrospectively analyzed. Patients treated with Apixaban were compared to those treated with VKA. Data on demographics, clinical presentations, risk factors, radiological and outcome parameters were studied.
Overall, 403 patients were included in the analysis. Of them, 48 (12%) were treated with Apixaban, and 355 (88%) were treated with VKA. Rates of coagulopathies were significantly higher in the VKA-treated patients but no other differences between the groups were found in baseline characteristics and underlying etiology. No significant differences were found between groups in efficacy or safety parameters including the rates of recanalization, favorable outcomes, one-year mortality, seizures, intracranial hemorrhage or CSVT recurrences.
Our data suggests that Apixaban may be safe and effective for patients with CSVT. These results should be tested in prospective randomized clinical studies.
关于特定直接口服抗凝剂（DOAC）治疗脑窦和静脉血栓形成（CSVT）的安全性和有效性的信息稀缺。阿哌沙班是最常处方的DOAC之一。因此，我们旨在比较阿哌沙班与维生素K拮抗剂（VKA）在CSVT患者中的安全性和有效性。
对来自七个学术医学中心的前瞻性CSVT数据库进行回顾性分析。将接受阿哌沙班治疗的患者与接受VKA治疗的患者进行比较。研究了人口统计学、临床表现、危险因素、影像学和结局参数的数据。
总体而言，403例患者纳入分析。其中，48例（12%）接受阿哌沙班治疗，355例（88%）接受VKA治疗。VKA治疗的患者凝血障碍发生率显著更高，但两组在基线特征和潜在病因方面未发现其他差异。在疗效或安全性参数方面，包括再通率、良好结局、一年死亡率、癫痫发作、颅内出血或CSVT复发率，两组之间未发现显著差异。
我们的数据表明，阿哌沙班对CSVT患者可能是安全有效的。这些结果应在前瞻性随机临床研究中进行验证。
