Research News: Hereditary Hemorrhagic Telangiectasia WG publication on the safety of direct oral anticoagulants

The Hereditary Hemorrhagic Telangiectasia Working Group (HHT WG) has just published an article entitled Safety of direct oral anticoagulants in patients with hereditary hemorrhagic telangiectasia in the Orphanet Journal of Rare Diseases. It is equally co-authored by one member of EuroBloodNet.

This publication examined the safety of three direct oral anticoagulants (DOACs) – Apixaban, Rivaroxaban, and Dabigatran – in patients with HHT coming from eight VASCERN HHT centers of expertise in Denmark, France, Germany and Italy.

A retrospective audit was conducted in these centers and while DOACs had not been specifically recommended by these HHT centers (as warfarin is the anticoagulant of choice in HHT), 32 treatment episodes initiated by other clinicians in 28 patients reviewed at the centers were reported. These DOAC-treated HHT cases were then examined and analysed by the HHT WG in order to evaluate tolerance of these anticoagulants for HHT.

Conclusion: “Currently, conventional heparin and warfarin remain first choice anticoagulants in HHT. If newer anticoagulants are considered, although study numbers are small, at this stage Apixaban appears to be associated with lesser bleeding risk than Rivaroxaban.”

Download and read the full article here

We congratulate the HHT WG on this important publication!


Orphanet J Rare Dis. 2019 Aug 28;14(1):210. doi: 10.1186/s13023-019-1179-1.
Safety of direct oral anticoagulants in patients with hereditary hemorrhagic telangiectasia. Shovlin CL1, Millar CM2, Droege F3, Kjeldsen A4, Manfredi G5, Suppressa P6, Ugolini S7, Coote N8, Fialla AD4, Geisthoff U3, Lenato GM6, Mager HJ9, Pagella F7, Post MC9, Sabbà C6, Sure U3, Torring PM4, Dupuis-Girod S10, Buscarini E5; VASCERN-HHT.

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