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Dabigatran for catastrophic antiphospholipid syndrome
Edurne Sarrate1, Alejandro Olive2, Cristian Morales-Indiano3
1Hematology Laboratory. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona.
Vitamin K antagonists are standard for catastrophic antiphospholipid syndrome (CAPS). In a case study, dabigatran, a direct oral anticoagulant, successfully prevented thrombosis in a CAPS patient non-responsive to other treatments.
Area of Science:
- Internal Medicine
- Hematology
- Pharmacology
Background:
- Catastrophic Antiphospholipid Syndrome (CAPS) is a rare, severe condition requiring anticoagulation.
- Vitamin K antagonists (VKA) are the primary treatment, but alternatives are needed for non-responders.
Observation:
- A patient with CAPS and psychiatric disorder exhibited non-compliance with VKA and low-molecular-weight heparin.
- The patient was transitioned to dabigatran, a direct oral anticoagulant (DOAC).
Findings:
- The patient remained thrombosis-free for 8 years on dabigatran.
- Despite progressive renal failure, dabigatran levels remained within the therapeutic range.
Implications:
- Dabigatran may serve as a viable therapeutic alternative for high-risk APS patients unresponsive to VKAs.
- This case highlights the potential of DOACs in complex CAPS management.
- Further research is warranted to explore DOAC efficacy in APS management.
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