Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome
Authors: Josefina Cortés-Hernández
Journal: Annals of Internal Medicine (2020)

Letters15 September 2020Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid SyndromeJosefina Cortés-Hernández, MD, PhDJosefina Cortés-Hernández, MD, PhDVall d'Hebrón Research Institute, Barcelona, Spain (J.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0054 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I would like to respond to 2 previously published comments on my article (1). Dr. Moll (2) raised concern about possible bias caused by favoring enrollment of patients who tended to respond well to vitamin K antagonists (VKAs). To clarify, patient selection at enrollment was not based on response to VKAs. In addition to stable recipients of VKAs, our study included 28 patients (14.7%) with antiphospholipid syndrome (APS) with a history of recurrent thrombosis despite treatment with VKAs who were receiving high-intensity anticoagulation (international normalized ratio, 3.1 to 4.0). After randomization, the distribution in both cohorts was similar ...References1. Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, et al. Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome. A randomized noninferiority trial. Ann Intern Med. 2019;171:685-94. [PMID: 31610549] LinkGoogle Scholar2. Moll S. Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome. Ann Intern Med. 2020;172:510. [PMID: 32252075]. doi:10.7326/L20-0053 LinkGoogle Scholar3. Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018;132:1365-1371. [PMID: 30002145] doi:10.1182/blood-2018-04-848333 CrossrefMedlineGoogle Scholar4. Leong D, Wu PE. Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome. Ann Intern Med. 2020;172:509-510. [PMID: 32252074]. doi:10.7326/L20-0052 LinkGoogle Scholar5. Di Minno A, Frigerio B, Spadarella G, et al. Old and new oral anticoagulants: food, herbal medicines and drug interactions. Blood Rev. 2017;31:193-203. [PMID: 28196633] doi:10.1016/j.blre.2017.02.001 CrossrefMedlineGoogle Scholar6. Herink MC, Zhuo YF, Williams CD, et al. Clinical management of pharmacokinetic drug interactions with direct oral anticoagulants (DOACs). Drugs. 2019;79:1625-1634. [PMID: 31440911] doi:10.1007/s40265-019-01183-0 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Vall d'Hebrón Research Institute, Barcelona, Spain (J.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0291. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Josep Ordi-Ros , Luis Sáez-Comet , Mercedes Pérez-Conesa , Xavier Vidal , Antoni Riera-Mestre , Antoni Castro-Salomó , Jordi Cuquet-Pedragosa , Vera Ortiz-Santamaria , Montserrat Mauri-Plana , Cristina Solé , and Josefina Cortés-Hernández Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Stephan Moll Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Derek Leong and Peter E. Wu Metrics 15 September 2020Volume 173, Issue 6Page: 505-506 ePublished: 15 September 2020 Issue Published: 15 September 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...