“I do not recommend changing to a direct oral anticoagulant at this time for our patients with APS,” she said
For treatment of APS in pregnancy, Dr. Sammaritano’s main message was to use low-dose aspirin in combination with low-dose heparin, usually enoxaparin, when there is more risk involved for the patient. Combination therapy is standard for patients who have had complications of obstetric APS, such as recurrent early, or a single later, fetal loss. The treatment approach may be considered for high-risk individuals who do not meet standard obstetric APS criteria in some cases, however, she said.
“If your patients have a lot of risk factors, we can be flexible in using combination therapy,” she said. “If they’ve had one miscarriage, but they’re 40, had to go through IVF and are triple positive, I would add enoxaparin to that patient’s [treatment] rather than wait for them to have three early miscarriages.”
Thomas R. Collins is a freelance writer living in South Florida.
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