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Thrombotic APS — SCE Rheumatology MCQ

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ModerateConnective tissue diseasesThrombotic APSSCE Rheumatology

A 40-year-old man has APS with an unprovoked proximal DVT and persistent lupus anticoagulant positivity. Examination shows no bleeding risk is identified. Investigations show platelets are 142 x 10^9/L and renal function is normal. What is the most appropriate management?

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Correct answer: C — Long-term vitamin K antagonist anticoagulation

Thrombotic APS is usually managed with long-term vitamin K antagonist anticoagulation, especially in high-risk antibody profiles. Aspirin alone is inadequate after a venous thrombotic event. Direct oral anticoagulants are generally avoided in high-risk APS because of concern about recurrent thrombosis.

Reference: EULAR recommendations; BSR guideline; BNF