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ANCA Vasculitis — SCE Rheumatology MCQ

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HardVasculitisANCA VasculitisSCE Rheumatology

A patient with definite triple-positive antiphospholipid syndrome completes heparin treatment for a first unprovoked proximal DVT. There is no arterial event and bleeding risk is acceptable. Which long-term regimen is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Long-term warfarin targeting an INR of 2.0–3.0

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E

C is correct. EULAR recommends long-term VKA anticoagulation with target INR 2–3 after a first unprovoked venous thrombosis in APS. Higher-intensity warfarin has not shown additional benefit for a first venous event. Rivaroxaban should not be used in triple-positive APS, and aspirin or a fixed six-month LMWH course provides inadequate secondary prevention.

Reference: EULAR recommendations for antiphospholipid syndrome. https://ard.bmj.com/content/78/10/1296