Direct oral anticoagulant failure in patients with venous thromboembolism—why and what next?

IF 5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2025-04-06 DOI:10.1016/j.jtha.2025.03.026
Dawn Swan , Robert Turner , Erik Lerkevang Grove , Sam Schulman , Jecko Thachil
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Abstract

Management of recurrent thrombotic events in patients taking a direct oral anticoagulant can be challenging. In this review, we consider causes of so-called direct oral anticoagulant failure, from poor adherence, malabsorption, and drug interactions to the presence of undiagnosed antiphospholipid syndrome, cancer-associated thrombosis, severe thrombophilia, vasculitis, and other rare causes. We discuss the known or potential pathogenesis of venous thromboembolism recurrence in these situations and provide practical guidance to assist clinicians faced with these challenging cases.
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静脉血栓栓塞患者直接口服抗凝药物失效的原因和下一步怎么办?
直接服用口服抗凝剂的患者复发性血栓事件的管理具有挑战性。在这篇综述中,我们考虑了所谓DOAC失败的原因,从依从性差、吸收不良和药物相互作用到未确诊的抗磷脂综合征、癌症相关血栓形成、严重血栓形成、血管炎和其他罕见原因。我们讨论在这些情况下静脉血栓栓塞复发的已知或潜在的发病机制,并提供实用的指导,以帮助临床医生面对这些具有挑战性的病例。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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