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Antiphospholipid Syndrome: Can the New Oral Anticoagulants Be Used?
Stephan Moll, MD and Damon Houghton, MD write … In patients with antiphospholipid syndrome (APS) who require anticoagulation for the treatment of DVT or PE, warfarin or a low molecular weight heparin have traditionally been used. A question that comes up is whether one of the new oral anticoagulants (DOACs) can be effectively and safely…
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Apixaban (Eliquis) FDA-Approval for DVT and PE Treatment
Stephan Moll, MD writes… Apixaban (Eliquis®) was approved by the FDA this week (Aug 21, 2014) for the treatment of DVT and PE. The approval covers (a) acute DVT/PE management and (b) prevention of recurrent DVT/PE.
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Pregnancy, Breastfeeding – Safety of Various Anticoagulants
Stephan Moll, MD writes… LMWH (low molecular weight heparin) is the preferred anticoagulant in the pregnant patient. LMWH and warfarin are safe in the woman who is beast-feeding. Rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis) should not be used during pregnancy or while breastfeeding. A detailed summary about the safety of the various anticoagulants during pregnancy…
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Handout for Your Patients in Clinic – Which Anticoagulant to Use for DVT and PE
Stephan Moll, MD writes… Patients who are on warfarin for a history of DVT or PE may inquire whether a switch to one of the new oral anticoagulants is appropriate. Similarly, many physicians initiate this discussion with their patients. This is, obviously, a detailed discussion and an individualized decision with a number of factors to be considered.…
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Reversing Warfarin for Urgent Surgeries – Extended FDA Approval of Kcentra
Stephan Moll, MD writes… The FDA approved today (Dec 13th, 2013) the use of the drug Kcentra® for urgent warfarin reversal in patients who need an urgent surgical procedure. This extends the indications for use of this drug – it had been approved by the FDA in April 2013 to treat major bleeding on warfarin…
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FDA Approval of New Drug to Treat Major Bleeding on Warfarin – Kcentra
Stephan Moll, MD writes… A new drug for the urgent reversal of warfarin was approved by the FDA today, April 29th, 2013 (announcement by the FDA is here), called Kcentra. The drug is derived from pooled plasma from healthy blood donors and contains the coagulation factors that are low in warfarin-treated patients, i.e. factors II, VII,…
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Warfarin Failure
Stephan Moll, MD writes… Occasionally, recurrent DVT or PE occur in spite of warfarin therapy, particularly in patients with (a) fluctuating and sub-therapeutic INRs, (b) lupus anticoagulant/ antiphospholipid antibody (APLA) syndrome or (c) cancer.
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Top 10 Publications on Thrombosis and Anticoagulation from 2012
Stephan Moll writes… 2012 has been a year with significant progress in the field of venous thromboembolism and anticoagulation. The three most noteworthy, clinically relevant developments were probably (a) the publication of the new ACCP (American College of Chest Physician) guidelines on antithrombotic therapy in February 2012; (b) The FDA-approval of rivaroxaban (Xarelto) in November 2012 for the acute…
