Sistema computacional para o monitoramento da anticoagulação oral em pacientes com Síndrome do Anticorpo Antifosfolipídio: APSOnCloud

Abstract

Antiphospholipid Syndrome (APS) is an autoimmune disease characterized by recurrent thromboses and fetal losses with the presence of persistent antiphospholipid antibodies. The main treatment to prevent recurrent thrombotic events is, in addition to controlling traditional risk factors, the life-time oral anticoagulation with vitamin K antagonist (VKA). This requires frequent monitoring of the prothrombin time (PT) and calculation of the INR (international normalized ratio) with subsequent dosage adjustments. Outpatient anticoagulation monitoring has its limitations, such as patients spending long hours between the testing procedure and waiting for the results to be adjusted by the medical team. To optimize this adjustment, empower patients and to improve APS patient-doctor relationship, we developed a website to help monitor APS patients, called APSOnCloud. In order to test it, since 2014, we registered so-far 23 APS patients that have inserted 211 INR values, of which 50.7% were within therapeutic range. The mean time in therapeutic range using Rosendaal's method was 59.9%. It took in average 6 hours for the doctor in charge to adjust out of range values. Our preliminary experience in monitoring VKA oral anticoagulation on APSOnCloud suggests that APS patients might benefit from this web-based monitoring.