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Primary APS Prophylaxis — RACP Adult Medicine MCQ

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EasyRheumatologyPrimary APS ProphylaxisRACP Adult Medicine

A 30-year-old woman with systemic lupus erythematosus is found to have antiphospholipid antibodies but no history of thrombosis or pregnancy loss. She asks about primary thromboprophylaxis. What is recommended?

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Correct answer: A — Low-dose aspirin (100 mg daily)

For asymptomatic antiphospholipid antibody carriers (no prior thrombosis or pregnancy morbidity), particularly those with SLE, low-dose aspirin (100 mg daily) is recommended for primary thromboprophylaxis. The evidence is based on the APLASA trial and observational studies. Anticoagulation is reserved for documented thrombotic events. During pregnancy, women with antiphospholipid antibodies but no prior obstetric morbidity may also benefit from low-dose aspirin.

Reference: eTG – 2025 – Rheumatology; EULAR – 2019 – APS Recommendations