AUTHOR=Simaan Naaem , Metanis Issa , Honig Asaf , Hallevi Hen , Filioglo Andrei , Mendel Rom , Barnea Rani , Naftali Jonathan , Auriel Eitan , Aladdin Shorooq , Orion David , Dally Najib , Leker Ronen R. , Molad Jeremy TITLE=Efficacy and safety of Apixaban in the treatment of cerebral venous sinus thrombosis: a multi-center study JOURNAL=Frontiers in Neurology VOLUME=15 YEAR=2024 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1404099 DOI=10.3389/fneur.2024.1404099 ISSN=1664-2295 ABSTRACT=Background

Information regarding the safety and efficacy of specific direct oral anticoagulants (DOAC) in the treatment of cerebral sinus and venous thrombosis (CSVT) is scarce. Apixaban is one of the most frequently prescribed DOACs. Therefore, we aimed to compare the safety and efficacy of Apixaban with those of vitamin k antagonists (VKA) in patients with CSVT.

Methods

Prospective CSVT databases from seven academic medical centers were retrospectively analyzed. Patients treated with Apixaban were compared to those treated with VKA. Data on demographics, clinical presentations, risk factors, radiological and outcome parameters were studied.

Results

Overall, 403 patients were included in the analysis. Of them, 48 (12%) were treated with Apixaban, and 355 (88%) were treated with VKA. Rates of coagulopathies were significantly higher in the VKA-treated patients but no other differences between the groups were found in baseline characteristics and underlying etiology. No significant differences were found between groups in efficacy or safety parameters including the rates of recanalization, favorable outcomes, one-year mortality, seizures, intracranial hemorrhage or CSVT recurrences.

Conclusion

Our data suggests that Apixaban may be safe and effective for patients with CSVT. These results should be tested in prospective randomized clinical studies.