Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

53 questions · 54 findings · 18 reviews

No studies found 6 · 11.1%GRADE not reported 5 · 9.3%Very low 10 · 18.5%Low 13 · 24.1%Moderate 11 · 20.4%High 9 · 16.7%

ASA with LMWH vs placebo or IVIG

Bleeding ‐ major (bleeding requiring transfusion) Length of · people with antiphospholipid antibodies and no history of thrombosis

ASA with LMWH showed no clear difference in bleeding ‐ major (bleeding requiring transfusion) Length of compared with placebo or IVIG (moderate certainty).

1 finding from 1 review

Thromboelastography threshold vs standard of care (laboratory parameters)

Major bleeding · patients undergoing non‐cardiac surgery/invasive procedures

It is very uncertain whether thromboelastography threshold changes major bleeding within 24 hours № of participants: 60 (1 RCT) compared with standard of care (laboratory parameters) (very low certainty).

1 finding from 1 review

Prophylactic plasma transfusion before surgery/invasive procedures vs alternative haemostatic agents

Bleeding ‐ major/excessive · patients undergoing non‐cardiac surgery/invasive procedures

It is very uncertain whether prophylactic plasma transfusion before surgery/invasive procedures changes major bleeding within 24 hours № of participants: 21 (1 RCT) compared with alternative haemostatic agents (very low certainty).

1 finding from 1 review

Prophylactic plasma transfusion before surgery/invasive procedures vs no prophylactic plasma transfusion before surgery/invasive procedures (colloid, crystalloid, placebo, or no treatment)

Major bleeding · patients undergoing non‐cardiac surgery/invasive procedures

It is very uncertain whether prophylactic plasma transfusion before surgery/invasive procedures changes major bleeding within 24 hours № of participants: 148 (2 RCTs) compared with no prophylactic plasma transfusion before surgery/invasive… (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs standard local care

Major bleeding, requiring transfusion of packed red blood cells · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in major bleeding requiring transfusion of packed red blood cells compared with standard care (usual local haemostatic measures: gelatin sponge and…; GRADE not reported.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Major bleeding, requiring transfusion of packed red blood cells · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in major bleeding requiring transfusion of packed red blood cells compared with placebo (placebo solution/mouthwash); GRADE not reported.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Bleeding duration (minutes, all types of bleeding, minor and major) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

The review found no eligible studies for this question.

1 finding from 1 review

Vitamin K antagonists vs placebo

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

The review found no eligible studies for this question.

1 finding from 1 review

Heparin vs placebo

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

The review found no eligible studies for this question.

1 finding from 1 review

DOAC vs placebo

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

DOAC showed no clear difference in bleeding‐ clinically relevant non‐major Treatment duration 28 ‐ 42… compared with placebo (moderate certainty).

1 finding from 1 review

Vitamin K antagonists vs heparin

Bleeding ‐ clinically indicated non‐major Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

The review found no eligible studies for this question.

1 finding from 1 review

DOAC vs heparin

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

DOAC showed no clear difference in bleeding ‐ clinically relevant, non‐major Treatment duration 28 ‐ 42… compared with heparin (high certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs one antiplatelet agent

Any bleeding that does not meet criteria for major bleeding ‐ Gastrointestinal bleeding (no definition) · people with antiphospholipid syndrome, with previous stroke

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes any bleeding that does not meet criteria for major bleeding ‐… compared with single antiplatelet agent (very low certainty).

1 finding from 1 review