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The Growing Potential of Direct Oral Anticoagulants in Hypercoagulable States
Authors: Julianne M Fallon*, Surabhi Palkimas, Paul R Kunk and Hillary S Maitland

The direct oral anticoagulants are being increasingly used as alternatives to warfarin in patients with venous thromboembolism and atrial fibrillation. The role of these agents in Hypercoagulable states, such as heparin induced thrombocytopenia and antiphospholipid syndrome has not yet been proven in randomized controlled trials. In addition, the lack of clinical experience with DOACs in these Hypercoagulable states raises questions on the safety and efficacy of these agents for treatment. However, a growing multitude of clinical reports provides some insight into the utility of DOACs in Hypercoagulable disease states. A keyword search utilizing PubMed was performed to identify reports of DOAC use in HIT and APS. Direct oral anticoagulants possess their own unique advantages and limitations when compared to standard therapy for these disease states. This review was conducted to compile the current evidence for the direct oral anticoagulants in heparin induced thrombocytopenia and antiphospholipid syndrome along with the potential advantages and disadvantages of these medications compared to the current standard treatment.

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