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Catastrophic antiphospholipid syndrome — SCE Rheumatology MCQ

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HardConnective Tissue DiseasesCatastrophic antiphospholipid syndromeSCE Rheumatology

A woman with triple-positive antiphospholipid antibodies has a first unprovoked proximal DVT. Which long-term antithrombotic strategy is preferred after initial heparin treatment?

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

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Correct answer: C — Use long-term vitamin K antagonist treatment at standard intensity

The best answer is “Use long-term vitamin K antagonist treatment at standard intensity”. For thrombotic antiphospholipid syndrome after a first venous event, long-term vitamin K antagonist treatment at standard intensity is preferred; direct oral anticoagulants are avoided in triple-positive high-risk APS. Aspirin or dual antiplatelet treatment is inadequate for a proximal DVT, and symptom resolution does not remove recurrence risk.

Reference: EULAR antiphospholipid syndrome recommendations: https://pmc.ncbi.nlm.nih.gov/articles/PMC11034817/