Cochrane · systematic review · CD012534
Antiplatelet and anticoagulant agents for primary prevention of thrombosis in individuals with antiphospholipid antibodies
Bala, MM, Paszek, E, Lesniak, W, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
VascularAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
8
No studies
8
Included studies
NR
No studies 8 · 32%Ungraded 9 · 36%Very low 0 · 0%Low 5 · 20%Moderate 3 · 12%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Anticoagulant with or without ASA versus ASA only
Population: people with antiphospholipid antibodies and no history of thrombosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thrombosis Median Anticoagulant with or without ASA vs ASA only | RR 0.98 [0.25, 3.77] | 4 studies · 493 participants | Low Downgraded: risk of bias |
Bleeding ‐ major Anticoagulant with or without ASA vs ASA only | no estimate extracted | 4 studies · 493 participants | Ungraded |
Bleeding ‐ minor (not requiring hospital admission) Median Anticoagulant with or without ASA vs ASA only | RR 22.45 [1.34, 374.81] | 1 study · 164 participants | Low Downgraded: imprecision |
Mortality Anticoagulant with or without ASA vs ASA only | no estimate extracted | NR | No studies |
Quality of life Anticoagulant with or without ASA vs ASA only | no estimate extracted | NR | No studies |
Adverse event other than bleeding Anticoagulant with or without ASA vs ASA only | no estimate extracted | 2014 participants | Ungraded |
ASA versus placebo
Population: people with antiphospholipid antibodies and no history of thrombosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thrombosis ASA vs placebo | RR 5.21 [0.63, 42.97] | 1 study · 98 participants | Low Downgraded: risk of bias, imprecision |
Bleeding ‐ major ASA vs placebo | no estimate extracted | 1 study · 98 participants | Ungraded |
Bleeding ‐ minor ASA vs placebo | RR 3.13 [0.34, 29.01] | 1 study · 98 participants | Low Downgraded: risk of bias, imprecision |
Mortality ASA vs placebo | no estimate extracted | NR | No studies |
Quality of life ASA vs placebo | no estimate extracted | NR | No studies |
Adverse event other than bleeding ASA vs placebo | no estimate extracted | 5 participants | Ungraded |
ASA with LMWH versus placebo or IVIG
Population: people with antiphospholipid antibodies and no history of thrombosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thrombosis Up to 2 months postpartum in Dendrinos 2009, not specified in Ismail 2016 ASA with LMWH vs placebo or IVIG | no estimate extracted | 2 studies · 258 participants | Ungraded |
Bleeding ‐ major (bleeding requiring transfusion) Length of ASA with LMWH vs placebo or IVIG | RR 9 [0.49, 164.76] | 1 study · 180 participants | Moderate Downgraded: imprecision |
Bleeding ‐ other (bleeding during first trimester) Length of ASA with LMWH vs placebo or IVIG | RR 0.89 [0.5, 1.61] | 1 study · 180 participants | Moderate Downgraded: imprecision |
Bleeding ‐ other (postpartum haemorrhage) Length of ASA with LMWH vs placebo or IVIG | RR 1.3 [0.6, 2.81] | 1 study · 180 participants | Moderate Downgraded: imprecision |
Mortality ASA with LMWH vs placebo or IVIG | no estimate extracted | NR | No studies |
Quality of life ASA with LMWH vs placebo or IVIG | no estimate extracted | NR | No studies |
Adverse events other than bleeding ASA with LMWH vs placebo or IVIG | no estimate extracted | 1 study · 3 participants | Ungraded |
ASA + high‐dose LMWH versus ASA + low‐dose LMWH or UFH
Population: people with antiphospholipid antibodies and no history of thrombosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thrombosis ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | no estimate extracted | 2 studies · 120 participants | Ungraded |
Bleeding ‐ major/excessive ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | no estimate extracted | 2 studies · 120 participants | Ungraded |
Subcutaneous bruises ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | RR 1 [0.34, 2.93] | 2 studies · 120 participants | Low Downgraded: risk of bias, imprecision |
Mortality ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | no estimate extracted | NR | No studies |
Quality of life ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | no estimate extracted | NR | No studies |
Adverse events other than bleeding ASA + high‐dose LMWH vs ASA + low‐dose LMWH or UFH | no estimate extracted | 1 participants | Ungraded |