Rivaroxaban vs. Warfarin for High-Risk Antiphospholipid Antibody Syndrome

Patients with antiphospholipid antibody syndrome (APS) that is triple positive (for lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein antibodies) are at high risk for thrombosis and are usually prescribed lifelong anticoagulation with warfarin. Direct-acting oral anticoagulants (DOACs), unlike warfarin, do not require monitoring and might be considered for patients with high-risk APS.

Now, investigators have conducted an industry-funded, multicenter, randomized, phase III trial to examine the safety and effectiveness of the DOAC rivaroxaban (20 mg daily) versus warfarin in patients with triple-positive APS. Patients assigned to warfarin had their international normalized ratio (INR) checked every 4 weeks, with a target INR of 2.…