Anticoagulantes orales directos en adultos con síndrome antifosfolipídico: revisión sistemática según las directrices PRISMA

Abstract

Introduction: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by a state of hypercoagulability. The current gold standard in its treatment is Warfarin, belonging to the vitamin K antagonists (VKA). However, new anticoagulants have been developed with the aim of obtaining better pharmacokinetic and pharmacodynamic profiles, thus direct oral anticoagulants (DOACs) have emerged as a possible therapeutic option (2). For this reason, the present Systematic Review selected updated articles on the efficacy and safety of DOACs versus Warfarin in adults with APS. Objective: To synthesize the available scientific evidence on Direct Oral Anticoagulants in adults with Antiphospholipid Syndrome. Method: An observational retrospective study of a Systematic Review of Literature based on the PRISMA methodology. The search included articles published between October of 2018 and October of 2023 on online databases: Scopus, PubMed, Science Direct, BVS, and Scielo. The instrument used for data collection was a data extraction matrix in Microsoft Excel 2016. The quality was evaluated using the Sackett scale and the risk of bias was evaluated using the ROBIS scale. Results: 14 articles were examined based on the eligibility criteria. 78% of these suggested that Warfarin is the preferred drug for patients with APS. Conclusions: New evidence continues to support Warfarin over DOACs as the drug of choice in patients diagnosed with high- and low-risk APS.