{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:28Z","timestamp":1787004868233,"version":"build-2736575974"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Individuals with inherited antithrombin deficiency (IATD) have a high risk of venous thromboembolism (VTE). Most VTEs are managed with direct oral anticoagulants (DOACs), but the utility of DOACs in antithrombin deficiency (ATD) is unreported.<\/jats:p>\n                  <jats:p>Patients with IATD treated with DOAC were identified from our institutions' IATD registry. We assessed patients' characteristics, ATD type, and initial VTE characteristics, thrombosis recurrence and bleeding rates.<\/jats:p>\n                  <jats:p>Thirty-three patients received DOACs for 73 (38.5\u2013111.5) months (median (interquartile range)). Prior to taking DOACs, 12 (36%) patients had VTE recurrence: these occurred after anticoagulation was ceased (4), nonadherence to VKA prior to DOAC use (3), or during heparin use in pregnancy (5). There were no VTE recurrences on standard-dose DOAC, except in a noncompliant patient receiving dabigatran. There was one recurrence with compliant DOAC use\u2014a patient receiving rivaroxaban 10\u2009mg. Six (18%) patients experienced clinically relevant bleeding, which was predominantly menorrhagia (5\/6). One major bleeding event, intracranial hemorrhage, occurred in a patient receiving full-dose rivaroxaban who had refractory hypertension (0.5 events\/100 patient-years). In this cohort, compliant DOAC users had an overall VTE recurrence rate of 0.5\/100 patient-years, whereas with low-dose DOACs the event rate was 3.5\/100 patient-years.<\/jats:p>\n                  <jats:p>Standard-dose DOACs appear efficacious and relatively safe in IATD.<\/jats:p>","DOI":"10.1055\/a-2379-7288","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T19:09:07Z","timestamp":1722884947000},"page":"379-384","source":"Crossref","is-referenced-by-count":10,"title":["The Efficacy and Safety of DOACs in Inherited Antithrombin Deficiency: A Cohort Study from a Tertiary Referral Center"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-128X","authenticated-orcid":false,"given":"Caroline","family":"Dix","sequence":"additional","affiliation":[{"name":"Haemophilia and Thrombosis Centre, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1001-0486","authenticated-orcid":false,"given":"Andrew J.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Haemophilia and Thrombosis Centre, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Breen","sequence":"additional","affiliation":[{"name":"Haemophilia and Thrombosis Centre, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley J.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Haemophilia and Thrombosis Centre, Guys and St. Thomas' NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"issue":"26","key":"ref1","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1182\/blood.2019002927","article-title":"How I treat patients with hereditary antithrombin deficiency","volume":"134","author":"I Pabinger","year":"2019","journal-title":"Blood"},{"issue":"05","key":"ref2","first-page":"695","article-title":"The risk of recurrent venous thromboembolism in patients with inherited deficiency of natural anticoagulants antithrombin, protein C and protein S","volume":"91","author":"V De Stefano","year":"2006","journal-title":"Haematologica"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1055\/s-0038-1625983","article-title":"Risk of venous thrombosis in antithrombin deficiency: a systematic review and Bayesian meta-analysis","volume":"44","author":"F N Croles","year":"2018","journal-title":"Semin Thromb Hemost"},{"issue":"S 01","key":"ref5","first-page":"S67","article-title":"Antithrombin deficiency and its laboratory diagnosis","volume":"48","author":"L Muszbek","year":"2010","journal-title":"Clin Chem Lab Med"},{"issue":"02","key":"ref6","first-page":"171","article-title":"SERPNIC1 gene mutations in antithrombin deficiency","volume":"178","author":"R Mulder","year":"2017","journal-title":"BJHaem"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa1302507","article-title":"Oral apixaban for the treatment of acute venous thromboembolism","volume":"369","author":"G Agnelli","year":"2013","journal-title":"N Engl J Med"},{"issue":"26","key":"ref8","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMoa1007903","article-title":"Oral rivaroxaban for symptomatic venous thromboembolism","volume":"363","author":"R Bauersachs","year":"2010","journal-title":"N Engl J Med"},{"issue":"15","key":"ref9","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1056\/NEJMoa1306638","article-title":"Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism","volume":"369","author":"H R B\u00fcller","year":"2013","journal-title":"N Engl J Med"},{"issue":"24","key":"ref10","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1056\/NEJMoa0906598","article-title":"Dabigatran versus warfarin in the treatment of acute venous thromboembolism","volume":"361","author":"S Schulman","year":"2009","journal-title":"N Engl J Med"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/jth.14398","article-title":"Direct oral anticoagulants in patients with venous thromboembolism and thrombophilia: a systematic review and meta-analysis","volume":"17","author":"M AT Elsebaie","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1055\/s-0040-1715647","article-title":"Direct oral anticoagulants in antithrombin deficiency: initial experience in a single centre","volume":"121","author":"B S Bhoelan","year":"2021","journal-title":"Thromb Haemost"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/bjh.18239","article-title":"Thrombophilia testing: a British Society for Haematology guideline","volume":"198","author":"D J Arachchillage","year":"2022","journal-title":"Br J Haematol"},{"issue":"11","key":"ref15","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1111\/jth.13140","article-title":"Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH","volume":"13","author":"S Kaatz","year":"2015","journal-title":"J Thromb Haemost"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/jth.13336","article-title":"Categorization of patients as having provoked or unprovoked venous thromboembolism: guidance from the SSC of ISTH","volume":"14","author":"C Kearon","year":"2016","journal-title":"J Thromb Haemost"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/jth.14648","article-title":"Recommendations for clinical laboratory testing for antithrombin deficiency; communication from the SSC of the ISTH","volume":"18","author":"E M Van Cott","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref18","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1207541","article-title":"Apixaban for extended treatment of venous thromboembolism","volume":"368","author":"G Agnelli","year":"2013","journal-title":"N Engl J Med"},{"issue":"13","key":"ref19","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1056\/NEJMoa1700518","article-title":"Rivaroxaban or aspirin for extended treatment of venous thromboembolism","volume":"376","author":"J I Weitz","year":"2017","journal-title":"N Engl J Med"},{"issue":"09","key":"ref20","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1161\/01.ATV.0000174806.76629.7b","article-title":"Recurrence rate after a first venous thrombosis in patients with familial thrombophilia","volume":"25","author":"C Y Vossen","year":"2005","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1160\/TH08-06-0364","article-title":"High long-term absolute risk of recurrent venous thromboembolism in patients with hereditary deficiencies of protein S, protein C or antithrombin","volume":"101","author":"J LP Brouwer","year":"2009","journal-title":"Thromb Haemost"},{"issue":"10","key":"ref22","first-page":"868","article-title":"Antithrombin deficiency as a still underdiagnosed thrombophilia: a primer for internists","volume":"130","author":"C Bravo-P\u00e9rez","year":"2020","journal-title":"Pol Arch Intern Med"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1055\/s-0037-1616525","article-title":"Homozygous antithrombin deficiency type II (99 Leu to Phe mutation) and childhood thromboembolism","volume":"86","author":"S Kuhle","year":"2001","journal-title":"Thromb Haemost"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2379-7288.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T19:55:02Z","timestamp":1743537302000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2379-7288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,5]]},"references-count":21,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,4,1]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2379-7288","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8,5]]},"published":{"date-parts":[[2024,8,5]]}}}