Fifty percent of people with systemic lupus erythematosus (SLE) have anti-phospholipid antibody syndrome (APS), a condition that can lead to life-threatening blood clots and pregnancy morbidity
In a review by TS Vadgama, et al., published online July 26 in the journal Lupus, the authors evaluate primary and secondary thromboprophylaxis in patients with anti-phospholipid autoantibodies (aPL) and a history of thrombosis.
The authors highlighted seven key findings:
1) A risk-stratified approach is preferred in primary thromboprophylaxis, but aPL status, comorbidities and cardiovascular vascular need to be considered.
2) There have been good and poor results for the use of low-dose aspirin in primary thromboprophylaxis. The mixed results may be due to poorly designed studies.
3) For aPL carriers, warfarin may not work for venous and/or arterial thrombosis. It is also associated with safety concerns.
4) Hydroxychloroquine use is not entirely conclusive to date, but the preliminary data is encouraging.
5) For kidney transplant patients with secondary thromboprophylaxis, warfarin may be the best option.
6) Aspirin is not recommended.
7) The jury is out on rivaroxaban because the data, of which there is little, is contradictory.
See next page: "Systemic lupus erythematosus increases the risk of blood clot formation."