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Direct oral anticoagulants (DOACs) have replaced warfarin as the anticoagulant of choice in most clinical situations. However, warfarin has remained as the recommended anticoagulant for patients with antiphospholipid antibody syndrome (APS), based on superiority over the DOAC rivaroxaban. Apixaban has not been studied.
To determine whether apixaban 2.5 mg twice daily would be safe and effective compared with warfarin (targeting an international normalized ratio of 2–3) in thrombotic APS patients, investigators conducted a prospective, randomized, controlled trial. The primary outcome was a composite including thrombosis (arterial and venous) and vascular death.
Key result were as follows:
48 patients were enrolled (including 83.3% women) with …