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Is there any evidence to support co-prescribing aspirin and warfarin to patients with antiphospholipid syndrome who have suffered a DVT ?

Associated tags: antiphospholipid syndrome, aspirin, Cardiovascular disease, combination therapy, DVT, warfarin

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Question answered:11/04/07 Warning! this question is over two years old.

A search of the TRIP database found one systematic review (1) and two guidelines (2-3) which discuss the investigation and management of antiphospholipid syndrome. However, there appears to be no discussion of combination treatment of warfarin and aspirin in the management of venous thrombosis.

A search of Pubmed found one 2002 review (4) of the anticoagulation regimens used in patients with antiphospholipid syndrome found “Combination therapy of warfarin and aspirin (ASA) does not offer an improvement in the expected utility over warfarin alone”

Given this lack of evidence you may want to discuss the situation with a hospital-based specialist.

References

1) Lim, W. Crowther, M.A. et al. Management of antiphospholipid syndrome. A systematic review. JAMA. 2006;25(9)1050-1057 (http://jama.ama-assn.org/cgi/content/abstract/295/9/1050)
2) BCSH Haemostasis and Thrombosis Task Force (2000) Guideline for the investigation and management of antiphospholipid syndrome. British Journal of Haematology. 109, 704-715 (http://www.bcshguidelines.com/pdf/bjh2069.pdf)
3) http://www.tigc.org/eguidelines/antiphoslipid04.htm
4) Brunner, HI, Chan WS et al. Longterm anticoagulation is preferable for patients with antiphospholipid antibody syndrome. result of a decision analysis. Journal of Rheumatology. 2002. (3):490-501. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11908562)

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