The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.
Low Molecular Weight Heparin and Aspirin for Recurrent Pregnancy Loss: Results from the Randomized, Controlled HepASA Trial
Open accessAbstract
Objective.: To compare live birth rates in women with recurrent pregnancy loss (RPL) and either autoantibodies or a coagulation abnormality, treated with low molecular weight heparin plus aspirin (LMWH/ASA) or ASA alone, and to place our results in context with other randomized clinical trials (RCT) with similar cohorts. Methods.: The HepASA Trial was an RCT including patients with a history of RPL and at least 1 of the following: antiphospholipid antibody (aPL), an inherited thrombophilia, or antinuclear antibody. Treatment groups were stratified by aPL status and history of early versus late pregnancy losses. Patients received either LMWH/ASA or ASA alone. The primary outcome was live birth; secondary outcomes included adverse events and bone loss at the spine and femoral neck. Literature over the past 20 years was reviewed to identify comparable RCT. Results.: Over 4 years, 859 women with RPL were screened: 88 (10.2%) fulfilled inclusion criteria, became pregnant and were randomized to receive either LMWH/ASA or ASA alone. aPL were present in 42 (47.7%) patients in each group. The trial was stopped after 4 years when an interim analysis showed no difference in live birth rates in the 2 groups, and a lower rate of pregnancy loss in the ASA only group than expected. In the LMWH/ASA group, 35/45 (77.8%) had a live birth versus 34/43 (79.1%) in the ASA only group (p = 0.71). Neither number of prior losses nor aPL status was correlated with pregnancy outcome. There were no cases of pregnancy related thrombosis in either group. Mean change in BMD did not differ by treatment group at either the lumbar spine (p = 0.57) or femoral neck (p = 0.15). RCT since 2000 for aPL positive women with RPL and similar inclusion criteria report a mean live birth rate of 75% with either LMWH or ASA. Conclusion.: LMWH/ASA did not confer incremental benefit compared to ASA alone for this population. Regardless of treatment regimen, number of prior losses, or aPL positivity, almost 80% of women in our RPL cohort had a successful pregnancy outcome. These findings contribute to a growing body of literature that contests the emerging standard of care comprising LMWH/ASA for this population.
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“Pooled data from one RCT including only patients with a history of first trimester losses46 and eight supporting observational studies47–54 that did not exclusively study women with early pregnancy losses indicated a higher likelihood of live births with combination treatment with LDA and heparin at prophylactic dosage versus LDA alone.”
From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [54]
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The 1982 revised criteria for the classification of systemic lupus erythematosus
Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., Mcshane, D. J., Rothfield, N. F., Schaller, J. G., Talal, N., & Winchester, R. J. (1982) · Arthritis & Rheumatism · doi:10.1002/art.1780251101 · Cited by 14,519
Incidence of early loss of pregnancy
Wilcox, A. J., Weinberg, C. R., O'Connor, J. F., Baird, D. D., Schlatterer, J. P., Canfield, R. E., Armstrong, E. G., & Nisula, B. C. (1988) · New England Journal of Medicine · doi:10.1056/nejm198807283190401 · Cited by 2,354
A New and Improved Population-Based Canadian Reference for Birth Weight for Gestational Age
Kramer, M. S., Platt, R. W., Wen, S. W., Joseph, K. S., Allen, A. C., Abrahamowicz, M., Blondel, B., Bréart, G., & Bréart, G. (2001) · PEDIATRICS · doi:10.1542/peds.108.2.e35 · Cited by 1,526
Rai, R., Cohen, H., Dave, M., & Regan, L. (1997) · BMJ · doi:10.1136/bmj.314.7076.253 · Cited by 1,113
Thrombophilic disorders and fetal loss: a meta-analysis
Rey, E., Kahn, S. R., David, M., & Shrier, I. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12771-7 · Cited by 872
Kutteh, W. H. (1996) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(96)70610-5 · Cited by 807
Increased fetal loss in women with heritable thrombophilia
Preston, F., Rosendaal, F., Walker, I., Briët, E., Berntorp, E., Conard, J., Fontcuberta, J., Makris, M., Mariani, G., Noteboom, W., et al. (1996) · The Lancet · doi:10.1016/s0140-6736(96)04125-6 · Cited by 661
Cowchock, F. S., Reece, E. A., Balaban, D. J., Branch, D. W., & Plouffe, L. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(92)91596-3 · Cited by 585
Pregnancy Loss in the Antiphospholipid-Antibody Syndrome — A Possible Thrombogenic Mechanism
Rand, J. H., Wu, X.-X., Andree, H. A. M., Lockwood, C. J., Guller, S. M., Scher, J., & Harpel, P. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199707173370303 · Cited by 519
Prevention of recurrent miscarriage for women with antiphospholipid antibody or lupus anticoagulant
Empson, M. B., Lassere, M., Craig, J. C., & Scott, J. R. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002859.pub2 · Cited by 486
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Research works printed but not linked: 3
- Carson SA Branch DW . ACOG Practice Bulletin 24. Management of recurrent early pregnancy loss. 2002 Compendium of Selected Publications. Washington, DC: American College of Obstetricians and Gynecologists; 2001:372–83.
- Ramsay Goldman, 1988, Pregnancy in systemic lupus erythematosus, Rheum Dis Clin North Am, 14, 169, 10.1016/S0889-857X(21)00953-4 · DOI
- Spitzer, 2002, Prevalence of inherited thrombophilias in women with unexplained recurrent pregnancy loss, Arthritis Rheum, 46, S231
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Items 101–103 of 103
Liu, X., Qiu, Y., Yu, E. D., Xiang, S., Meng, R., Niu, K. F., & Zhu, H. (2020) · American Journal of Reproductive Immunology · doi:10.1111/aji.13219 · Cited by 29
Zhang, T., Ye, X., Zhu, T., XIAO, X., Liu, Y., Wei, X., Liu, Y., Wu, C., Guan, R., Li, X., et al. (2015) · Medicine · doi:10.1097/md.0000000000001732 · Cited by 28
Enoxaparin and aspirin therapy for recurrent pregnancy loss due to anti-phospholipid syndrome (APS)
Mohamed, K. A. A., & Saad, A. S. (2014) · Middle East Fertility Society Journal · doi:10.1016/j.mefs.2013.12.004 · Cited by 20
Metadata
- Authors
- LASKIN, C. A., SPITZER, K. A., CLARK, C. A., CROWTHER, M. R., GINSBERG, J. S., HAWKER, G. A., KINGDOM, J. C., BARRETT, J., & GENT, M.
- Affiliations
- University of Toronto (CA)
- Mount Sinai Hospital (CA)
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2009-02
- Volume
- 36
- Issue
- 2
- Pages
- 279-287
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2022226231
- Cited by
- 352
- References
- 43
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 10 · 2023: 12 · 2022: 13 · 2021: 11 · 2020: 18 · 2019: 19 · 2018: 16 · 2017: 33 · 2016: 11 · 2015: 28 · 2014: 33 · 2013: 22 · 2012: 19
- FWCI
- 15.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Pfizer Canada
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- recurrent pregnancy loss, low molecular weight heparin, aspirin, antiphospholipid antibodies, antithrombotic therapy, live birth rate, bone mineral density, inherited thrombophilia, antinuclear antibodies, pregnancy loss prevention, adverse events, bone loss
- MeSH terms
- Abortion, Habitual, Adult, Anticoagulants, Antibodies, Antinuclear, Aspirin, Autoimmune Diseases, Blood Coagulation Disorders, Female, Heparin, Low-Molecular-Weight, Humans, Platelet Aggregation Inhibitors, Pregnancy, Pregnancy Complications, Hematologic, Cohort Studies, Bone Density, Antiphospholipid Syndrome, Treatment Outcome, Thrombophilia
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