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Original Article

Aspirin or heparin or both in the treatment of recurrent spontaneous abortion in women with antiphospholipid antibody syndrome: a meta-analysis of randomized controlled trials

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Pages 1299-1311 | Received 21 Jun 2017, Accepted 10 Nov 2017, Published online: 10 Jan 2018

References

  • Kuon R-J, Wallwiener L-M, Germeyer A, et al. Establishment of a standardized immunological diagnostic procedure in RM patients. J Reprod Immunol. 2012;94(1):55.
  • Christiansen OB, Nybo Andersen AM, Bosch E, et al. Evidence-based investigations and treatments of recurrent pregnancy loss. Fertil Steril. 2005;83(4):821–839.
  • Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(5):839–854.
  • Del RT, Ruffatti A, Visentin MS, et al. Treatment of 139 pregnancies in antiphospholipid-positive women not fulfilling criteria for antiphospholipid syndrome: a retrospective study. J Rheumatol. 2013;40:392–402.
  • D’Ippolito S, Meroni PL, Koike T, et al. Obstetric antiphospholipid syndrome: A recent classification for an old defined disorder. Autoimmun Rev. 2014;13(9):901–908.
  • Salmon JE, Girardi G, Lockshin MD. The antiphospholipid syndrome as a disorder initiated by inflammation: implications for the therapy of pregnant patients. Nat Clin Pract Rheumatol. 2007;3(3):140–7; quiz 1 p following 187.
  • Oku K, Amengual O, Atsumi T. Pathophysiology of thrombosis and pregnancy morbidity in the antiphospholipid syndrome. Eur J Clin Invest. 2012;42(10):1126–1135.
  • Espinola RG, Liu X, Colden-Stanfield M, et al. E-Selectin mediates pathogenic effects of antiphospholipid antibodies. J Thromb Haemost. 2003;1(4):843–848.
  • Di Simone N, Raschi E, Testoni C, Castellani R, D’Asta M, Shi T, Krilis SA, Caruso A, Meroni PL, et al. Pathogenic role of anti-beta 2-glycoprotein I antibodies in antiphospholipid associated fetal loss: characterisation of beta 2-glycoprotein I binding to trophoblast cells and functional effects of anti-beta 2-glycoprotein I antibodies in vitro. Ann Rheum Dis. 2005;64(3):462–467.
  • Di Simone N, Di Nicuolo F, D’Ippolito S, Castellani R, Tersigni C, Caruso A, Meroni P, Marana R, et al. Antiphospholipid antibodies affect human endometrial angiogenesis. Biol Reprod. 2010;83(2):212–219.
  • Girardi G, Yarilin D, Thurman JM, et al. Complement activation induces dysregulation of angiogenic factors and causes fetal rejection and growth restriction. J Exp Med. 2006;203(9):2165–2175.
  • Rai RS, Clifford K, Cohen H, et al. High prospective fetal loss rate in untreated pregnancies of women with recurrent miscarriage and antiphospholipid antibodies. Hum Reprod. 1995;10(12):3301–3304.
  • Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295–306.
  • Allison JL, Schust DJ. Recurrent first trimester pregnancy loss: revised definitions and novel causes. Curr Opin Endocrinol Diabetes Obes. 2009;16(6):446–450.
  • Cayol V, Reznikoff MF, Trabelsi K, et al. Role of aspirin in the preventive treatment of recurrent miscarriages. Rev Prat Gynecol Obstet. 2001:21–22.
  • Gerosa M, Chighizola C, Meroni PL. Aspirin in asymptomatic patients with confirmed positivity of antiphospholipid antibodies? Yes (in some cases). Intern Emerg Med. 2008;3(3):201–203.
  • Bose P, Kadyrov M, Goldin R, et al. Aberrations of early trophoblast differentiation predispose to pregnancy failure: lessons from the anti-phospholipid syndrome. Placenta. 2006;27(8):869–875.
  • Dahl OE, Eriksson BI, Agnelli G, et al. Postoperative melagatran/ximelagatran for the Prevention of venous thromboembolism following Major Elective Orthopaedic Surgery. Clin Drug Invest. 2005;25(1):65–77.
  • Girardi G, Redecha P, Salmon JE. Heparin prevents antiphospholipid antibody-induced fetal loss by inhibiting complement activation. Nat Med. 2004;10(11):1222–1226.
  • Walker ID, Kujovich JL, Greer IA. The use of LMWH in pregnancies at risk: new evidence or perception? J Thromb Haemost. 2005;3(4):778–779.
  • Alijotas-Reig J, Vilardell-Tarres M. Is obstetric antiphospholipid syndrome a primary nonthrombotic, proinflammatory, complement-mediated disorder related to antiphospholipid antibodies? Obstet Gynecol Surv. 2010;65(1):39–45.
  • Derksen RH, Khamashta MA, Branch DW. Management of the obstetric antiphospholipid syndrome. Arthritis Rheum. 2004;50(4):1028–1039.
  • Kwak-Kim J, Agcaoili MSL, Aleta L, et al. Management of women with recurrent pregnancy losses and antiphospholipid antibody syndrome. Am J Reprod Immunol. 2013;69(6):596–607.
  • Hoppe B, Burmester GR, Dörner T. Heparin or aspirin or both in the treatment of recurrent abortions in women with antiphospholipid antibody (syndrome). Curr Opin Rheumatol. 2011;23(3):299–304.
  • Empson MB, Lassere M, Craig JC, et al. Prevention of recurrent miscarriage for women with antiphospholipid antibody or lupus anticoagulant. Cochrane Database Syst Rev. 2005:CD002859:CD002859.
  • Ziakas PD, Pavlou M, Voulgarelis M. Heparin treatment in antiphospholipid syndrome with recurrent pregnancy loss: a systematic review and meta-analysis. Obstet Gynecol. 2010;115:997–998. Author reply:8.
  • Mak A, Cheung MWL, Cheak AA, et al. Combination of heparin and aspirin is superior to aspirin alone in enhancing live births in patients with recurrent pregnancy loss and positive anti-phospholipid antibodies: a meta-analysis of randomized controlled trials and meta-regression. Rheumatology. 2010;49(2):281–288.
  • Zhang T, Ye X, Zhu T, et al. Antithrombotic treatment for recurrent miscarriage:bayesian network meta-analysis and systematic review. Medicine. 2015;94(45):e1732.
  • Andreoli L, Chighizola CB, Banzato A, et al. Estimated frequency of antiphospholipid antibodies in patients with pregnancy morbidity, stroke, myocardial infarction, and deep vein thrombosis: a critical review of the literature. Arthritis Care Res. 2013;65(11):1869–1873.
  • Pierangeli SS, de Groot PG, Dlott J, et al. ‘Criteria’ aPL tests: report of a task force and preconference workshop at the 13th International Congress on Antiphospholipid Antibodies, Galveston, Texas, April 2010. Lupus. 2011;20(2):182–190.
  • Ruffatti A, Salvan E, Del Ross TD, et al. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity. A European multicentre retrospective study. Thromb Haemost. 2014;112(4):727–735.
  • Mekinian A, Alijotas-Reig J, Carrat F, et al. Refractory obstetrical antiphospholipid syndrome: features, treatment and outcome in a European multicentre retrospective study. Autoimmun Rev. 2017.
  • Mekinian A, Costedoat-Chalumeau N, Masseau A, et al. Obstetrical APS: is there a place for hydroxychloroquine to improve the pregnancy outcome? Autoimmun Rev. 2015;14(1):23–29.
  • Kutteh WH. Antiphospholipid antibody-associated recurrent pregnancy loss: treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone. Am J Obstet Gynecol. 1996;174(5):1584–1589.
  • Rai R, Cohen H, Dave M, et al. Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies). BMJ. 1997;314(7076):253–257.
  • Farquharson R, Kent N. Antiphospholipid syndrome in pregnancy: a randomized, controlled trial of treatment. Obstet Gynecol. 2002;100(3):408–413.
  • Franklin RD, Kutteh WH. Antiphospholipid antibodies (APA) and recurrent pregnancy loss: treating a unique APA positive population. Hum Reprod. 2003;18:1553–4; author reply 1554. author reply:4.
  • Triolo G, Ferrante A, Ciccia F, et al. Randomized study of subcutaneous low molecular weight heparin plus aspirin versus intravenous immunoglobulin in the treatment of recurrent fetal loss associated with antiphospholipid antibodies. Arthritis Rheumatol. 2003;48:728–731.
  • Goel N, Tuli A, Choudhry R. The role of aspirin versus aspirin and heparin in cases of recurrent abortions with raised anticardiolipin antibodies. Med Sci Monit. 2006;12(3):CR132–CR136.
  • Dendrinos S, Sakkas E, Makrakis E. Low-molecular-weight heparin versus intravenous immunoglobulin for recurrent abortion associated with antiphospholipid antibody syndrome. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2009;104(3):223–225.
  • Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA, Kingdom JC, Barrett J, Gent M, et al. Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial. J Rheumatol. 2009;36(2):279–287.
  • Mohamed KAA, Saad AS. Enoxaparin and aspirin therapy for recurrent pregnancy loss due to anti-phospholipid syndrome (APS). Middle East Fertil Soc J. 2014;19(3):176–182.
  • Ismail AM, Hamed AH, Saso S, et al. Randomized controlled study of pre-conception thromboprophylaxis among patients with recurrent spontaneous abortion related to antiphospholipid syndrome. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2016;132(2):219–223.
  • Zhou X. The effect of aspirin combined with low molecular weight heparin in treatment of 30 patients with habitual abortion and antiphospholipid syndrome. Cn Mod Doct. 2012;50:60–62.
  • Tang H, Huang MY, Tan Y. Effect of low molecular weight heparin combined with low-dose aspirin for ACA positive recurrent spontaneous abortion. Hainan Med J. 2012;23:13–14.
  • Cowchock S, Reece EA. Do low-risk pregnant women with antiphospholipid antibodies need to be treated? Organizing Group of the Antiphospholipid Antibody Treatment Trial Am J Obstet Gynecol. 1997;176(5):1099–1100.
  • Tulppala M, Marttunen M, Söderstrom-Anttila V, et al. Low-dose aspirin in prevention of miscarriage in women with unexplained or autoimmune related recurrent miscarriage: effect on prostacyclin and thromboxane A2 production. Hum Reprod. 1997;12(7):1567–1572.
  • Pattison NS, Chamley LW, Birdsall M, et al. Does aspirin have a role in improving pregnancy outcome for women with the antiphospholipid syndrome? A randomized controlled trial. Am J Obstet Gynecol. 2000;183(4):1008–1012.
  • Cowchock FS, Reece EA, Balaban D, et al. Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose heparin treatment. Am J Obstet Gynecol. 1992;166(5):1318–1323.
  • Guo LJ. Study of heparin on pregnant woman with recurrent pregnant loss and positive anti-phospholipid antibody. China Prac Med. 2013;8:57–59.
  • Bu MX. Clinical observation 40 autoimmune habitual abortion patients with low molecular weight heparin calcium. China Prac Med. 2009;4:73–74.
  • Fu JH, Wang ZY, Lang FF. Study of heparin on pregnant woman with recurrent pregnant loss and positive anti-phospholipid antibody. Chin J Perinat Med. 2004;7:276–278.

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