PB0971 - Antiphospholipid syndrome in adult male patients in Mexico.

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Stephania Sandoval Ocampo, Hematologist

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Ciudad de méxico, Mexico City, Mexico

Co-Author(s)

Adriana G. Garcia

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
ML

María Graciela Leal Gutiérrez

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Emely J. Soriano, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Andric Cuevas-Juárez, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico city, Distrito Federal, Mexico
TM

Tania Marisol Martinez Garcia

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Marilyn G. Mendoza, MD

Medical resident on thrombosis and hemostasis
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico
Margarita M. Thomas, MD

Medical Resident on Thrombosis and Hemostasis
1Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico city, Distrito Federal, Mexico
JA

José A. Aguilar Hidalgo

Medical Resident
UNIDAD DE INVESTIGACIÓN MÉDICA EN TROMBOSIS, HEMOSTASIA Y ATEROGÉNESIS. INSTITUTO MEXICANO DEL SEGURO SOCIAL
Ciudad de México, Distrito Federal, Mexico
Abraham S. Majluf

Head of the thrombosis and hemostasis unit
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Mexico City, Distrito Federal, Mexico

Background: Information regarding APS (Antiphospholipid syndrome) in male patients is scarce.

Aims: The main objective was to identify the demographics characteristics of a cohort of mexican male patients with APS.

Methods: A prospective, comparative cohort study, included patients between January 2003 and December 2023.

Results: Results of 66 patients (40 and 26 with primary and secondary APS, respectively), with a median age of 26.5 years-old (range: 16-57), were analyzed. Diseases associated with secondary APS included: SLE (n=9), RA (n=7), Sjögren syndrome (n=2), HIV infection (n=2), cancer (n=3), and hematological malignancies (n=3). Mean of thrombosis at diagnosis of APS was 1.8 (ranges: 1-4). At entering the study, 12 patients (18.2%), did not receive anticoagulant treatment and five (7.6%) only received ASA. During the first years, patients received VKAs (INR: 2.0-3.0+ASA 100 mg OD; TTR: 25%). Since 2008, they were switched to or initially treated with either, rivaroxaban (15 mg OD) or apixaban (2.5 mg TD) + ASA 100mg OD. During follow-up, thromboses occurred in 4 and 5, double or triple-positive patients, respectively; all had lupus anticoagulant. Main causes of death were renal failure (n=2), cancer progression (n=2), acute myocardial infarction (n=1), pulmonary embolism (n=1). Treatment included 265 patient/year (VKA+ASA) vs. 469 patient/year (DOAC+ASA). Initially, AVK+ASA treatment was indicated in 17 patients and then, they were switched to DOAC+ASA. Two patients treated with VKA+ASA never received DOAC+ASA. From 2018 up to 2023, all patients received DOAC+ASA. Table 1 shows thrombotic events, development of post-thrombotic complications, major and minor bleeding, secondary effects, and death.

Conclusion(s): TTR in the VKA+ASA group was very low, a not surprising observation when VKAs are indicated in APS. In this long-term follow-up study, we show DOAC in APS are effective and safe. A significant reduction in thrombotic episodes, thrombosis-related complications, and bleeding was found with DOAC.