Only one individual had to be infused with FIX concentrate for any?suspected ankle bleed 2?days after vector infusion

Only one individual had to be infused with FIX concentrate for any?suspected ankle bleed 2?days after vector infusion. this short review, Selp we try to highlight the most important presentations during the ASH meeting 2016. strong class=”kwd-title” Keywords: Hemophilia, Gene transfer, Anticoagulation, Malignancy, Atrial fibrillation Take home message Rivaroxaban is definitely noninferior to fondaparinux for treatment of symptomatic superficial vein thrombosis In malignancy individuals with atrial fibrillation, the use of DOACs Acetanilide is safe Acetanilide for stroke prevention Gene transfer probably a?potential treatment option in patients with hemophilia?B in the near future Intro The annual meeting of the American Society of Hematology (ASH) was held in San Diego/California from December 3C6, 2016. As every year, a?broad spectrum of important developments is definitely hematologybut also in hemostaseologywas discussed by numerous experts. Highlights in the field of hemophilia included the demonstration on adeno-associated disease mediated gene transfer in individuals with hemophilia?B during this years plenary session [1]. Another novel treatment option in individuals with hemophilia?A was discussed highlighting a?humanized bispecific antibody mimicking FVIIIa activity [2]. Relating to anticoagulation, data on the use of direct oral anticoagulants (DOACs) in malignancy individuals with atrial fibrillation [3] and treatment of superficial vein thrombosis (SVT) with rivaroxaban [4] were offered. This review will summarize probably the most relevant topics during the ASH meeting 2016 for the daily medical work. Rivaroxaban vs. fondaparinux in the treatment of superficial vein thrombosis Management of SVT is based on the risk assessment of developing deep-vein thrombosis and pulmonary embolism (PE). Treatment includes in the low-risk establishing topical treatment or nonsteroidal anti-inflammatory medicines (NSAID), in intermediate risk situations fondaparinux 2.5?mg daily for 45?days or intermediate dose low molecular excess weight heparin (LMWH; for 4C6?weeks), and for high-risk individuals restorative anticoagulation with vitamin?K antagonists (VKA) or DOACs for 3?weeks (Table?1; [5]). The recommendation for the use of fondaparinux is mainly based on the CALISTO trial [6], a?randomized prospective trial including 3002 patients with SVT. The results showed a?significant reduction by fondaparinux compared to placebo of the composite endpoint (death from any cause, symptomatic PE or deep vein thrombosis, or extension to the saphenofemoral junction or symptomatic recurrence of SVT; [6]). Table 1 Treatment recommendations for superficial vein thrombosis ( em SVT /em ) of the lower limb (adapted after [5]) thead th rowspan=”1″ colspan=”1″ SVT C risk stratification /th th rowspan=”1″ colspan=”1″ Localization/thrombus size /th th rowspan=”1″ colspan=”1″ Treatment /th /thead Low riskThrombus size 4C5?cm and 3?cm from saphenofemoral/saphenopopliteal junctionTopical or dental NSAID for 8?12?daysIntermediate riskThrombus length 4C5?cm and 3?cm from saphenofemoral/saphenopopliteal junctionFondaparinux 2.5?mg daily for 45?days or intermediate/restorative dose LMWH for 4C6 days or em Rivaroxaban 10?mg /em Large riskThrombus 3?cm from saphenofemoral/saphenopopliteal junctionTherapeutic anticoagulation as for DVT C VKA/DOAC for 3?month Open in a separate window Recommendations may change depending on the clinical history Acetanilide (e.?g., history of earlier Acetanilide VTE, active tumor) In the offered Surprise Trial (ASH# 85; [4]) Beyer-Westendorf et al. compared whether rivaroxaban, an direct oral element Xa inhibitor, is definitely noninferior to fondaparinux in the prevention of thromboembolic complications in individuals with SVT and at least one additional risk element (more than 65?years, male sex, previous venous thromboembolism, malignancy, autoimmune disease, thrombosis of nonvaricose veins). With this open-label randomized, noninferiority phase?3 trial, 472 individuals with symptomatic SVT were randomly assigned to the rivaroxaban group (10?mg oral, em n /em ?= 236) or the 2 2.5?mg fondaparinux group (2.5?mg subcutaneous, em n /em ?= 236). Treatment was given once a?day time for 45?days. In all, 435 individuals were included in Acetanilide the analysis. The primary effectiveness outcome occurred in 7 (3%) of 211 individuals in the rivaroxaban group and in 4 (2%) of 224 individuals in the fondaparinux group ( em p /em ?= 0.0025 for noninferiority) at day time?45. There were no major bleeds in either group. As a result, the authors pointed out that rivaroxaban was noninferior to fondaparinux for treatment of SVT in terms of.