Evaluation of Warfarin versus Direct Oral Anticoagulants in Patients with Inherited Thrombophilia Megan Bereda,Lydia Newsom,Kathryn Momary,Jonathan Masor,Mary Bailey Jones Emory University Hospital - Atlanta, GA
Background/Purpose: Patients with inherited thrombophilia are at increased risk of venous thromboembolism (VTE). The most common inherited thrombophilia include Factor V Leiden and Prothrombin Gene 20210A (Factor II) mutation. With over half of VTE cases found to be in patients with thrombophilia, these conditions pose a clinical challenge in terms of treatment. The 2016 American College of Chest Physicians (ACCP) Antithrombic Therapy guidelines favor the use of direct oral anticoagulants (DOACs) for the acute treatment of VTE but only mention thrombophilia as a risk factor. The 2012 CHEST Antithrombotic Guidelines fail to recommend DOACs due to lack of clinical use and availability at the time. Historically, patients with thrombophilia have been treated with warfarin, but in comparison DOACs offer many advantages including less potential for food and drug interactions, shorter half-life, and no routine laboratory monitoring. The primary outcome of this study is to assess the treatment and secondary prevention of VTE by analyzing VTE recurrence within a one-year period in patients with minor thrombophilia.
Methodology: A retrospective chart review was performed for patients with Factor V Leiden and/or Prothrombin 20210A mutation initiated on anticoagulation within the Emory Healthcare Clinics for venous thromboembolism from January 1, 2014 to September 1, 2018. Data collected includes patient demographics, mutation zygosity, VTE recurrence, bleeding events, and healthcare utilization during the one year follow up period. VTE recurrence and bleeding events in patients receiving warfarin versus DOACs were compared using descriptive statistics.
Presentation Objective: Compare the safety and efficacy of DOACs to warfarin in patients with minor thrombophilia.
Self-Assessment: Are DOACs as safe and efficacious as warfarin for patients with minor thrombophilia?
