Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?   

I would certainly consider stopping anticoagulation in selected patients after an in-depth discussion about potential risks and benefits. I would not consider stopping AC in patients with a history of recurrent events, arterial events, or multiple risk factors for thrombosis (e.g. nephrotic syndrome...

The problem in these situations is that you cannot predict with any degree of confidence if such a patient would have another thromboembolic episode after stopping the anticoagulant. And it could be a serious event, e.g., a stroke. If he/she does, then you are in hot water from a medico-legal standp...

My concern in the situation has is always been the ability to effectively evaluate the parameters of thrombosis. Patients taking warfarin cannot be completely assessed for their lupus anticoagulant. Many patients with antiphospholipid antibody syndrome also have other factor deficiencies that contri...