ASH evidence-based guidelines: should asymptomatic patients with antiphospholipid antibodies receive primary prophylaxis to prevent thrombosis?
A 35-year-old female presents with a prolonged activated partial thromboplastin time (aPTT) on routine testing, which is found to be due to a lupus anticoagulant. She has no medical issues, no personal or family history of thrombosis, no history of pregnancy loss, and no symptoms suggestive of an underlying rheumatologic disorder. She is a non-smoker and does not take oral contraceptives. You are asked to provide recommendations regarding the need for primary thromboprophylaxis. As you begin your literature search, you formulate the following clinical question: "In asymptomatic patients with antiphospholipid antibodies, does primary prophylaxis prevent thrombotic complications?"
Metjian
Ara
A
Department of Medicine, Division of Hematology, Duke University, Durham, NC, USA.
Lim
Wendy
W
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D033162:Incidental Findings; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D010314:Partial Thromboplastin Time; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000592:standards*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012016:Reference Values; D013923:Thromboembolism / Q000517:prevention & control*; D019851:Thrombophilia / Q000188:drug therapy*; D019564:Unnecessary Procedures
D000925:Anticoagulants; D016682:Lupus Coagulation Inhibitor; D006886:Hydroxychloroquine; D001241:Aspirin