Factor Xa inhibitors vs. warfarin in patients with Hughes syndrome: a systematic review and meta-analysis of randomized controlled trials
The optimal treatment regimen for patients with Hughes syndrome remains unclear. Therefore, the authors sought to compare the outcomes of warfarin vs. factor Xa inhibitors in patients with Hughes syndrome. MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials...
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Veröffentlicht in: | Annals of medicine and surgery 2024-05, Vol.86 (5), p.2992-3000 |
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creator | Mohtashim, Ali Azhar, Aima Mazhar, Saad Devi, Deepa Danial, Muhammad Patel, Dhruvilkumar Khan, Owais Andani, Anushka Khan, Muhammad Mohib Samad, Shahzaib Qureshi, Aena Ali, Hafsa Ejaz, Umer Jawad, Sayed |
description | The optimal treatment regimen for patients with Hughes syndrome remains unclear. Therefore, the authors sought to compare the outcomes of warfarin vs. factor Xa inhibitors in patients with Hughes syndrome.
MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) comparing 8 efficacy and safety of warfarin and factor Xa inhibitors in patients with Hughes syndrome. Recurrent thrombosis, all-cause mortality, stroke, adverse reactions, and bleeding were among 10 outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate 11 relative risks (RRs) with 95% CIs.
The analysis included 625 patients from four RCTs and one post-hoc analysis. Meta-analysis showed a statistically non-significant difference between factor Xa inhibitors and warfarin in the recurrent thrombosis risk (arterial or venous) [RR 2.77 (95%, CI 0.79, 9.65);
=0.11, I
=50%]. Consistent results were revealed among patients with a previous history of arterial thrombosis [RR 2.76 (95% CI 0.93, 8.16);
=0.75, I
=0%], venous thrombosis [RR 1.71 (95% CI 0.60, 4.84);
=0.31, I
=15%] and patients who were triple antiphospholipid antibodies (aPL) positive [RR 4.12 (95% CI 0.46, 37.10); 21
=0.21, I
=58%]. Factor Xa inhibitors were significantly associated with an increased risk of stroke [RR 8.51 (95% CI 2.35, 13.82);
=0.47, I
=0%].
Factor Xa inhibitors exhibited an increased risk of stroke among patients with Hughes syndrome. In addition, although not significant, the higher RRs among patients on factor Xa inhibitors may indicate a higher risk of thrombotic events associated with factor Xa inhibitors. |
doi_str_mv | 10.1097/MS9.0000000000001999 |
format | Article |
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MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) comparing 8 efficacy and safety of warfarin and factor Xa inhibitors in patients with Hughes syndrome. Recurrent thrombosis, all-cause mortality, stroke, adverse reactions, and bleeding were among 10 outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate 11 relative risks (RRs) with 95% CIs.
The analysis included 625 patients from four RCTs and one post-hoc analysis. Meta-analysis showed a statistically non-significant difference between factor Xa inhibitors and warfarin in the recurrent thrombosis risk (arterial or venous) [RR 2.77 (95%, CI 0.79, 9.65);
=0.11, I
=50%]. Consistent results were revealed among patients with a previous history of arterial thrombosis [RR 2.76 (95% CI 0.93, 8.16);
=0.75, I
=0%], venous thrombosis [RR 1.71 (95% CI 0.60, 4.84);
=0.31, I
=15%] and patients who were triple antiphospholipid antibodies (aPL) positive [RR 4.12 (95% CI 0.46, 37.10); 21
=0.21, I
=58%]. Factor Xa inhibitors were significantly associated with an increased risk of stroke [RR 8.51 (95% CI 2.35, 13.82);
=0.47, I
=0%].
Factor Xa inhibitors exhibited an increased risk of stroke among patients with Hughes syndrome. In addition, although not significant, the higher RRs among patients on factor Xa inhibitors may indicate a higher risk of thrombotic events associated with factor Xa inhibitors.</description><identifier>ISSN: 2049-0801</identifier><identifier>EISSN: 2049-0801</identifier><identifier>DOI: 10.1097/MS9.0000000000001999</identifier><identifier>PMID: 38694373</identifier><language>eng</language><publisher>England: Lippincott Williams & Wilkins</publisher><subject>Review</subject><ispartof>Annals of medicine and surgery, 2024-05, Vol.86 (5), p.2992-3000</ispartof><rights>Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060306/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060306/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38694373$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohtashim, Ali</creatorcontrib><creatorcontrib>Azhar, Aima</creatorcontrib><creatorcontrib>Mazhar, Saad</creatorcontrib><creatorcontrib>Devi, Deepa</creatorcontrib><creatorcontrib>Danial, Muhammad</creatorcontrib><creatorcontrib>Patel, Dhruvilkumar</creatorcontrib><creatorcontrib>Khan, Owais</creatorcontrib><creatorcontrib>Andani, Anushka</creatorcontrib><creatorcontrib>Khan, Muhammad Mohib</creatorcontrib><creatorcontrib>Samad, Shahzaib</creatorcontrib><creatorcontrib>Qureshi, Aena</creatorcontrib><creatorcontrib>Ali, Hafsa</creatorcontrib><creatorcontrib>Ejaz, Umer</creatorcontrib><creatorcontrib>Jawad, Sayed</creatorcontrib><title>Factor Xa inhibitors vs. warfarin in patients with Hughes syndrome: a systematic review and meta-analysis of randomized controlled trials</title><title>Annals of medicine and surgery</title><addtitle>Ann Med Surg (Lond)</addtitle><description>The optimal treatment regimen for patients with Hughes syndrome remains unclear. Therefore, the authors sought to compare the outcomes of warfarin vs. factor Xa inhibitors in patients with Hughes syndrome.
MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) comparing 8 efficacy and safety of warfarin and factor Xa inhibitors in patients with Hughes syndrome. Recurrent thrombosis, all-cause mortality, stroke, adverse reactions, and bleeding were among 10 outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate 11 relative risks (RRs) with 95% CIs.
The analysis included 625 patients from four RCTs and one post-hoc analysis. Meta-analysis showed a statistically non-significant difference between factor Xa inhibitors and warfarin in the recurrent thrombosis risk (arterial or venous) [RR 2.77 (95%, CI 0.79, 9.65);
=0.11, I
=50%]. Consistent results were revealed among patients with a previous history of arterial thrombosis [RR 2.76 (95% CI 0.93, 8.16);
=0.75, I
=0%], venous thrombosis [RR 1.71 (95% CI 0.60, 4.84);
=0.31, I
=15%] and patients who were triple antiphospholipid antibodies (aPL) positive [RR 4.12 (95% CI 0.46, 37.10); 21
=0.21, I
=58%]. Factor Xa inhibitors were significantly associated with an increased risk of stroke [RR 8.51 (95% CI 2.35, 13.82);
=0.47, I
=0%].
Factor Xa inhibitors exhibited an increased risk of stroke among patients with Hughes syndrome. In addition, although not significant, the higher RRs among patients on factor Xa inhibitors may indicate a higher risk of thrombotic events associated with factor Xa inhibitors.</description><subject>Review</subject><issn>2049-0801</issn><issn>2049-0801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpVUcFO3DAQtSqqghb-oKp87CXLeJ04cS8IIShIIA5Qqbdo4kxYV4m9tb27Wv6gf11XBbTM5b2ZeXqjmWHss4C5AF2f3j3oOeyF0Fp_YEcLKHUBDYiDPX7ITmL89U8ElVSq-cQOZaN0KWt5xP5coUk-8J_IrVvazuYk8k2c8y2GAYN1uc5XmCy5FPnWpiW_Xj8tKfK4c33wE33jmHlMNGWV4YE2lrYcXc8nSligw3EXbeR-4CFX_WSfqefGuxT8OGaagsUxHrOPQwY6ecEZ-3F1-XhxXdzef7-5OL8tVkLXqaiVqbWuQJFRg2jqBUAHWJYCQfRUdU1lANSwkKIxplOwKHXX9L0yNEgkJDljZ_99V-tuot7kvQKO7SrYCcOu9Wjb9x1nl-2T37RCgAIJKjt8fXEI_veaYmonGw2NIzry69hKqEDUpcrnnrEv-8Peprw-QP4F5wONeg</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Mohtashim, Ali</creator><creator>Azhar, Aima</creator><creator>Mazhar, Saad</creator><creator>Devi, Deepa</creator><creator>Danial, Muhammad</creator><creator>Patel, Dhruvilkumar</creator><creator>Khan, Owais</creator><creator>Andani, Anushka</creator><creator>Khan, Muhammad Mohib</creator><creator>Samad, Shahzaib</creator><creator>Qureshi, Aena</creator><creator>Ali, Hafsa</creator><creator>Ejaz, Umer</creator><creator>Jawad, Sayed</creator><general>Lippincott Williams & Wilkins</general><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240501</creationdate><title>Factor Xa inhibitors vs. warfarin in patients with Hughes syndrome: a systematic review and meta-analysis of randomized controlled trials</title><author>Mohtashim, Ali ; Azhar, Aima ; Mazhar, Saad ; Devi, Deepa ; Danial, Muhammad ; Patel, Dhruvilkumar ; Khan, Owais ; Andani, Anushka ; Khan, Muhammad Mohib ; Samad, Shahzaib ; Qureshi, Aena ; Ali, Hafsa ; Ejaz, Umer ; Jawad, Sayed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p197t-76c799506ec6f187200b0a441a01de5b85c006f2318ccb60249b8dd6cef3aeae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mohtashim, Ali</creatorcontrib><creatorcontrib>Azhar, Aima</creatorcontrib><creatorcontrib>Mazhar, Saad</creatorcontrib><creatorcontrib>Devi, Deepa</creatorcontrib><creatorcontrib>Danial, Muhammad</creatorcontrib><creatorcontrib>Patel, Dhruvilkumar</creatorcontrib><creatorcontrib>Khan, Owais</creatorcontrib><creatorcontrib>Andani, Anushka</creatorcontrib><creatorcontrib>Khan, Muhammad Mohib</creatorcontrib><creatorcontrib>Samad, Shahzaib</creatorcontrib><creatorcontrib>Qureshi, Aena</creatorcontrib><creatorcontrib>Ali, Hafsa</creatorcontrib><creatorcontrib>Ejaz, Umer</creatorcontrib><creatorcontrib>Jawad, Sayed</creatorcontrib><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of medicine and surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohtashim, Ali</au><au>Azhar, Aima</au><au>Mazhar, Saad</au><au>Devi, Deepa</au><au>Danial, Muhammad</au><au>Patel, Dhruvilkumar</au><au>Khan, Owais</au><au>Andani, Anushka</au><au>Khan, Muhammad Mohib</au><au>Samad, Shahzaib</au><au>Qureshi, Aena</au><au>Ali, Hafsa</au><au>Ejaz, Umer</au><au>Jawad, Sayed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factor Xa inhibitors vs. warfarin in patients with Hughes syndrome: a systematic review and meta-analysis of randomized controlled trials</atitle><jtitle>Annals of medicine and surgery</jtitle><addtitle>Ann Med Surg (Lond)</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>86</volume><issue>5</issue><spage>2992</spage><epage>3000</epage><pages>2992-3000</pages><issn>2049-0801</issn><eissn>2049-0801</eissn><abstract>The optimal treatment regimen for patients with Hughes syndrome remains unclear. Therefore, the authors sought to compare the outcomes of warfarin vs. factor Xa inhibitors in patients with Hughes syndrome.
MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) comparing 8 efficacy and safety of warfarin and factor Xa inhibitors in patients with Hughes syndrome. Recurrent thrombosis, all-cause mortality, stroke, adverse reactions, and bleeding were among 10 outcomes of interest. Mantel-Haenszel weighted random-effects model was used to calculate 11 relative risks (RRs) with 95% CIs.
The analysis included 625 patients from four RCTs and one post-hoc analysis. Meta-analysis showed a statistically non-significant difference between factor Xa inhibitors and warfarin in the recurrent thrombosis risk (arterial or venous) [RR 2.77 (95%, CI 0.79, 9.65);
=0.11, I
=50%]. Consistent results were revealed among patients with a previous history of arterial thrombosis [RR 2.76 (95% CI 0.93, 8.16);
=0.75, I
=0%], venous thrombosis [RR 1.71 (95% CI 0.60, 4.84);
=0.31, I
=15%] and patients who were triple antiphospholipid antibodies (aPL) positive [RR 4.12 (95% CI 0.46, 37.10); 21
=0.21, I
=58%]. Factor Xa inhibitors were significantly associated with an increased risk of stroke [RR 8.51 (95% CI 2.35, 13.82);
=0.47, I
=0%].
Factor Xa inhibitors exhibited an increased risk of stroke among patients with Hughes syndrome. In addition, although not significant, the higher RRs among patients on factor Xa inhibitors may indicate a higher risk of thrombotic events associated with factor Xa inhibitors.</abstract><cop>England</cop><pub>Lippincott Williams & Wilkins</pub><pmid>38694373</pmid><doi>10.1097/MS9.0000000000001999</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Review |
title | Factor Xa inhibitors vs. warfarin in patients with Hughes syndrome: a systematic review and meta-analysis of randomized controlled trials |
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