Do you recommend starting aspirin for a patient with ESKD secondary to lupus nephritis with detected antiphospholipid antibodies on pretransplant workup but no history of a thrombotic event?
Answer from: at Academic Institution
I agree. I tend to favor the use of Plaquenil in these APS patients although the data is not absolute either. I noticed that hematologists favor the use of the NOAC than Coumadin, and yet thus far, it appears that Coumadin, based on published data, prevents thrombosis better than other agents.
I offer it to my SLE patients (especially those with lupus nephritis) and discuss the pros and cons of using ASA plus HCQ for CV event prevention. I do this with all of my SLE patients.While our SLE patients as a whole are at high risk for CV events (top 1-2 causes), our patients with lupus nephriti...
While I recommend low-dose aspirin in patients with APL who are not on anticoagulants, I am not all that certain that this is more a "feel-good" measure than a true medical benefit. The studies on using ASA in APL patients are less than impressive, and the well-designed studies have not shown very m...