Direct oral anticoagulants and APS
The UK Medicines and Healthcare products Regulatory Agency (MHRA) has recently issued advice concerning use of direct oral anticoagulants (DOACs) in patients with APS. This advice may result in warfarin being preferred to DOACs for patients with APS until more evidence is available. The chief aim of drug treatment in patients with APS is to prevent blood clots or strokes. The main drug used for many years has been warfarin, which thins the blood. There is good evidence from clinical trials that warfarin is effective in preventing clots in patients with APS. There are some disadvantages to using warfarin. Patients have to have regular blood tests (called INR tests ) to make sure that the level of thinning of the blood is at just the right level – if the dose of warfarin is too high there is an increased risk of bleeding. Furthermore, warfarin interacts with a number of other medications so that when those drugs are being taken the INR tests may need to be done more frequently