Literature analysis of severe cutaneous adverse reactions induced by oral anticoagulants
- VernacularTitle:口服抗凝药物致严重皮肤不良反应的文献分析
- Author:
Shuang ZHENG
1
;
Rongrong JIANG
2
;
Jianguo ZHU
1
;
Cheng XIE
1
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Soochow University，Jiangsu Suzhou 215006，China
2. Dept. of Pharmacy，the First Affiliated Hospital of Soochow University，Jiangsu Suzhou 215006，China;Dept. of Pharmacy，Suzhou Hospital of Integrated Traditional Chinese and Western Medicine，Jiangsu Suzhou 215101，China
- Publication Type:Journal Article
- Keywords:
oral anticoagulants;
severe cutaneous adverse reactions;
Stevens-Johnson syndrome;
toxic epidermal necrolysis
- From:
China Pharmacy
2025;36(12):1500-1504
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the characteristics of severe cutaneous adverse reactions （SCARs） induced by oral anticoagulants （OACs）， and provide a reference for clinical safety of drug use. METHODS Case reports of SCARs caused by OACs （warfarin， apixaban， rivaroxaban， edoxaban， dabigatran etexilate） were retrieved from PubMed， Embase， CNKI， Wanfang Data， VIP and other databases with search terms as “oral anticoagulants”“factor Ⅹa inhibitor”“direct thrombin inhibitor” and their Chinese equivalents. A descriptive statistical analysis was performed. RESULTS A total of 11 articles were included， involving 11 patients in total， among whom there were 5 males （45.5%） and 6 females （54.5%）， with an average age of （59.6±21.5） years. The primary underlying diseases were mainly atrial fibrillation， pulmonary embolism， joint replacement and valve replacement. The OACs involved included warfarin in 3 cases， rivaroxaban in 4 cases， apixaban in 2 cases， and dabigatran etexilate in 2 cases. SCARs occurred from 10 hours to 42 days after treatment， and 7 cases （63.6%） within 10 to 28 days. Among 11 patients， 5 cases were diagnosed as drug reaction with eosinophilia and systemic symptoms， 4 cases were diagnosed as Stevens-Johnson syndrome or toxic epidermal necrolysis， and 2 cases were diagnosed as acute generalized exanthematous pustulosis. The clinical manifestations mainly included rash， fever and mucosal damage， etc. Except for 1 patient who died of sepsis and diffuse intravascular coagulation， the rest of the patients improved or recovered after withdrawal and treatment with glucocorticoids. CONCLUSIONS SCARs are rare but serious adverse reactions caused by OACs， typically occurring 10 to 28 days after medication. Once SCARs are suspected to be caused by OACs， the medication should be discontinued immediately， and a treatment plan should be formulated based on the type of SCARs to ensure the safety of patients’ drug use.
