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Direct oral anticoagulants versus warfarin in patients with antiphospholipid syndrome: A meta-analysis of randomized controlled trials
CONCLUSION: DOACs were associated with higher rates of arterial thrombosis than warfarin in patients with APS, especially in the triple-positive group. However, a higher risk of recurrent venous thrombosis was not found in APS patients treated with DOACs compared to those treated with warfarin.PMID:35968627 | DOI:10.1177/09612033221118463
Source: Lupus - August 15, 2022 Category: Rheumatology Authors: Young H Lee Gwan G Song Source Type: research

A trial of antithrombotic therapy in patients with refractory migraine and antiphospholipid antibodies: A retrospective study of 75 patients.
CONCLUSIONS: There was a high rate of symptomatic response to antithrombotic therapy in this context and long-term follow up suggested an individualized symptom-derived antithrombotic regimen may be associated with a low bleeding risk. Our data support consideration of a 2-4 week trial of antithrombotic therapy, usually starting with antiplatelet therapy, in aPL-positive patients with refractory migraine, particularly if other treatment options have been exhausted. As a retrospective study, our data provide only Class IV level of evidence, but they suggest randomized controlled trials are warranted to validate these enco...
Source: Lupus - January 5, 2021 Category: Rheumatology Authors: Schofield JR, Hughes HN, Birlea M, Hassell KL Tags: Lupus Source Type: research

Dorsolateral medullary infarction during skin infection by Stenotrophomonas maltophilia in a patient with triple antiphospholipid antibody positivity: a case-based review
AbstractThrombotic events are the most frequent causes of death in patients with antiphospholipid syndrome (APS). Previous studies have reported infection to be the most important trigger of thrombosis in APS, with molecular mimicry considered to be a major mechanism. Although timely management of infections has been recommended in patients with high suspicion of infection, anti-infective therapy would not take effect in a short time due to the dilemma in determining the origins of infection, especially in patients undergoing immunosuppressive therapy. Here, we describe a 26-year-old patient with systemic lupus erythematos...
Source: Clinical Rheumatology - November 5, 2020 Category: Rheumatology Source Type: research

Risk of bleeding events among patients with systemic sclerosis and the general population in the UK: a large population-based cohort study
ConclusionOur results are consistent with a moderately increased risk of bleeding in SSc patients. Further evidence from large SSc patient cohorts is needed to confirm this finding.Key Points•The risk of experiencing a major bleed may be higher among patients with SSc than the general population.•Further large and well-designed studies are needed to corroborate our findings.
Source: Clinical Rheumatology - May 13, 2019 Category: Rheumatology Source Type: research

Association Between Glucocorticoid Exposure and Healthcare Expenditures for Potential Glucocorticoid-related Adverse Events in Patients with Rheumatoid Arthritis.
CONCLUSION: Chronic exposure to low to medium doses of OGC was associated with significantly increased risk of potential OGC-related AE in patients with RA, and greater cumulative OGC dose was associated with substantially higher AE-related healthcare expenditures among patients with AE. PMID: 29335343 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - January 18, 2018 Category: Rheumatology Tags: J Rheumatol Source Type: research

Longterm Outcome of Patients with Primary Antiphospholipid Syndrome: A Retrospective Multicenter Study.
CONCLUSION: Despite therapy, a high proportion of patients experienced new thrombotic events and organ damage, while evolution toward CTD was infrequent. PMID: 28572466 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - June 3, 2017 Category: Rheumatology Tags: J Rheumatol Source Type: research

Rivaroxaban 'could be a safe treatment option for antiphospholipid syndrome'
The drug rivaroxaban could be an effective means of treating some patients with thromboticantiphospholipid syndrome, according to a new study. Led by University College London and funded byArthritis Research UK, the research has suggested that the drug - which works by inhibiting the formation of blood clots - could be a useful tool in the treatment of those with this serious condition, which affects approximately 15 per cent of patients withlupus and may also occur on its own. The danger of antiphospholipid syndrome Thrombotic antiphospholipid syndrome is classified as a rare condition, but is probably underdiagnosed. It ...
Source: Arthritis Research UK - August 29, 2016 Category: Rheumatology Source Type: news

Intracerebral hemorrhage with a favorable outcome in a patient with childhood primary angiitis of the central nervous system
We present the case of a boy with cPACNS that previously suffered an ischemic stroke. At the age of 7 years and 10 months, he presented a sudden and severe headache, vomiting and reduction in consciousness level (Glasgow coma scale 7), requiring prompt tracheal intubation. Brain computed tomography demonstrated intraparenchymal hematoma in the right parieto-occipital lobe and a small focus of bleeding in the right frontal lobe, vasogenic edema, herniation of the uncus and a 10 mm deviation to the left from the midline. C-reactive protein (9.2 mg/dL) and von Willebrand factor (vWF) antigen (202%) were elevated. Decompressiv...
Source: Revista Brasileira de Reumatologia - August 22, 2016 Category: Rheumatology Source Type: research

The impact of inflammatory rheumatic diseases on the presentation, severity, and outcome of acute coronary syndrome
Abstract Patients with inflammatory rheumatic diseases (IRD) have a high burden of cardiovascular disease (CVD), leading to increased mortality and morbidity. However, it is not clear whether increased CVD mortality in IRD is due to a higher incidence or worse outcome of cardiovascular events (higher case fatality). In this observational case–control study, we assessed the outcome of acute coronary syndrome (ACS) in patients with IRDs compared to matched controls without IRD, using data from the Acute Coronary Syndrome Israeli Survey (ACSIS), a large, national, real-life registry detailing the extent, severity,...
Source: Clinical Rheumatology - January 1, 2016 Category: Rheumatology Source Type: research

Intracerebral hemorrhage with a favorable outcome in a patient with childhood primary angiitis of the central nervous system
We present the case of a boy with cPACNS that previously suffered an ischemic stroke. At the age of 7 years and 10 months, he presented a sudden and severe headache, vomiting and reduction in consciousness level (Glasgow coma scale 7), requiring prompt tracheal intubation. Brain computed tomography demonstrated intraparenchymal hematoma in the right parieto-occipital lobe and a small focus of bleeding in the right frontal lobe, vasogenic edema, herniation of the uncus and a 10mm deviation to the left from the midline. C-reactive protein (9.2mg/dL) and von Willebrand factor (vWF) antigen (202%) were elevated. Decompressive ...
Source: Revista Brasileira de Reumatologia - December 1, 2015 Category: Rheumatology Source Type: research

Late‐onset primary antiphospholipid syndrome in the elderly: a report of seven cases
ConclusionIn this report, we report on primary APS in the elderly, to discuss its prevalence and the clinical significance of positive antiphospholipid antibodies in subjects over the age of 65 years.
Source: APLAR Journal of Rheumatology - December 20, 2014 Category: Rheumatology Authors: Yosra Cherif, Moez Jallouli, Hela Hriz, Radhouane Gouiaa, Sameh Marzouk, Mouna Snoussi, Faten Frikha, Hatem Masmoudi, Zouhir Bahloul Tags: Original Article Source Type: research

A discrete-choice experiment of United Kingdom patients' willingness to risk adverse events for improved function and pain control in osteoarthritis
Conclusion: Patients ranked ambulatory pain as a more important benefit than resting pain; likely due to its impact on ability to do daily activities. For a 25-mm reduction, patients were willing to accept four times the risk of MI in ambulatory pain vs resting pain.
Source: Osteoarthritis and Cartilage - January 23, 2013 Category: Rheumatology Authors: A.B. Hauber, N.K. Arden, A.F. Mohamed, F.R. Johnson, P.M. Peloso, D.J. Watson, P. Mavros, A. Gammaitoni, S.S. Sen, S.D. Taylor Tags: Original Articles Source Type: research