Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome
Bibliographic record
Abstract
Letters7 April 2020Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid SyndromeDerek Leong, RPh, BScPhm and Peter E. Wu, MD, MScDerek Leong, RPh, BScPhmUniversity Health Network, University of Toronto, Toronto, Ontario, Canada (D.L., P.E.W.)Search for more papers by this author and Peter E. Wu, MD, MScUniversity Health Network, University of Toronto, Toronto, Ontario, Canada (D.L., P.E.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0052 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Ordi-Ros and colleagues' study (1) comparing the efficacy and safety of rivaroxaban versus vitamin K antagonists (VKAs) for secondary thromboprophylaxis in patients with antiphospholipid antibody syndrome (APS) with interest. We were surprised that rivaroxaban not only did not show noninferiority to VKAs but also was associated with a nearly 2-fold increase (albeit a statistically nonsignificant one) in thrombotic events (rivaroxaban, 11.6%, vs. VKAs, 6.3%) (1). These results were similar to those from the TRAPS (Trial on Rivaroxaban in Antiphospholipid Syndrome) study done in patients with triple-positive APS (2). Why patients receiving rivaroxaban had a higher ...References1. Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, et al. Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome. A randomized noninferiority trial. Ann Intern Med. 2019;171:685-94. [PMID: 31610549] LinkGoogle Scholar2. Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018;132:1365-71. [PMID: 30002145] CrossrefMedlineGoogle Scholar3. Steffel J, Verhamme P, Potpara TS, et al; ESC Scientific Document Group. The 2018 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018;39:1330-93. [PMID: 29562325] CrossrefMedlineGoogle Scholar4. Shimada T, Terada A, Yokogawa K, et al. Lowered blood concentration of tacrolimus and its recovery with changes in expression of CYP3A and P-glycoprotein after high-dose steroid therapy. Transplantation. 2002;74:1419-24. [PMID: 12451243] CrossrefMedlineGoogle Scholar5. Usui T, Saitoh Y, Komada F. Induction of CYP3As in HepG2 cells by several drugs. Association between induction of CYP3A4 and expression of glucocorticoid receptor. Biol Pharm Bull. 2003;26:510-7. [PMID: 12673034] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Health Network, University of Toronto, Toronto, Ontario, Canada (D.L., P.E.W.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0052. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Josep Ordi-Ros , Luis Sáez-Comet , Mercedes Pérez-Conesa , Xavier Vidal , Antoni Riera-Mestre , Antoni Castro-Salomó , Jordi Cuquet-Pedragosa , Vera Ortiz-Santamaria , Montserrat Mauri-Plana , Cristina Solé , and Josefina Cortés-Hernández Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Stephan Moll Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome Josefina Cortés-Hernández Metrics Cited byRivaroxaban Versus Vitamin K Antagonist in Antiphospholipid SyndromeJosefina Cortés-Hernández, MD, PhD 7 April 2020Volume 172, Issue 7Page: 509-510KeywordsAnticoagulantsAntiphospholipid syndromeAttentionKidneysLiverSafetySafety studiesTherapeutic drug monitoringThrombosisVitamin K ePublished: 7 April 2020 Issue Published: 7 April 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".