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Direct Oral Anticoagulants Use in Antiphospholipid Syndrome: Are These Drugs an Effective and Safe Alternative to Warfarin? A Systematic Review of the Literature: Comment

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Hannah Cohen, Beverley J. Hunt, Maria Efthymiou, Ian J. Mackie, Munther Khamashta, David A. Isenberg, RAPS Trial Investigators

Original languageEnglish
Article number50
JournalCurrent Rheumatology Reports
Issue number8
Early online date20 Jul 2017
E-pub ahead of print20 Jul 2017
PublishedAug 2017


King's Authors


We respond to comments by Dufrost et al. about the RAPS trial, in particular, showing that the trial did achieve its target sample size; pointing out that thrombin potential is not synonymous with overall thrombin generation; confirming that overall, no increased thrombotic risk was evident comparing rivaroxaban with warfarin; and that high-risk patients (28% were triple positive, representative of patients with venous thromboembolism requiring standard-intensity anticoagulation) were included; and clarifying our rationale for using a laboratory surrogate primary outcome measure instead of a clinical one.

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