Anticoagulation of Systemic Sclerosis Patients In Question PDF Print E-mail
Saturday, 18 May 2013 23:43
Australia is in a state of ‘clinical equipoise’ over whether to anticoagulate systemic sclerosis patients with pulmonary hypertension, experts say. And with observational studies showing the treatment is associated with a  fivefold reduction in mortality, the issue demanded a prompt resolution, the team of rheumatologists wrote in this week’s Internal Medicine Journal.

Describing the issue as one of the “most contentious” in the management of patients with connective tissue disease, the doctors said anticoagulation was currently not regarded as standard care in these patients.

A previous study conducted by the authors had revealed that warfarin was used in around 30% of patients, with no Australian centres routinely anticoagulating patients. Practice also varied internationally, they said.

Acknowledging that systemic sclerosis patients had specific bleeding risks that made INR monitoring challenging, the authors said the recent advent of orally administered Xa inhibitors could overcome some of these issues.

“The preliminary evidence favouring a survival benefit with anticoagulation administered in conjunction with PAH-specific therapy makes a compelling case for evaluating its therapeutic efficacy in SSc-PAH,” the study authors wrote.

The authors called for a randomised controlled trial, arguing that a placebo arm was ethically justifiable because of uncertainty around the benefits and relative risks. “The substantially shortened life expectancy of patients with SSc-PAH further adds an element of urgency to the need to resolve this contentious issue,” they added.

Source: Rheumatology Update (2013), "Anticoagulant conundrum for PAH sclerosis"; original article can be viewed here.

 
More articles :

» How To Know If Your Body Is Acidic?

It can be really crucial to remember that the are normally based on the quantity of acids we have in our body. These signs and symptoms are grouped according to it order of severity. Much less severe symptoms may well indicate that you simply are...

» Quality Indicator Sets For Scleroderma

Despite the increasing awareness of Scleroderma (SSc), it continues to have a detrimental effect of the quality of health and lives of those with it. The medical community has recognized that although early treatment of can have a substantial...

» Unite Against Scleroderma 2014

For the fourth year running, we will be hosting our annual “Unite Against Scleroderma” Awareness Walk. Scheduled to start from 2:30pm, the Walk would be held on Saturday 3rd May, 2014 and cover one full lap around the Queen’s Park Savannah,...

» Potential Therapy for Scleroderma Lung Disease Uncovered

Investigators, partially supported by the , have found that a deficiency in the protein caveolin-1 (cav-1) is linked to the development of, the scarring of lung tissue that causes disability and death in people with . The scientists, from the...

» Systemic Sclerosis: A Bird’s Eye Review of Recent Literature

Pathogenesis and new therapeutical targetsTranscription factor Fos-related antigen-2 induces progressive peripheral vasculopathy in mice closely resembling human systemic sclerosis: In this study the authors investigated the potential pathogenetic...

» Scleroderma May Be Initated By Cancer

has reported that researchers at have discovered that some cases of are likely to have been initiated by Cancer.  In a landmark paper published in Science, researchers focusing on a select group of patients with both Scleroderma and Cancer,...