How long would you consider the use of low-dose aspirin in a patient with SLE and high risk aPL profile (without a clinical event)?

I recommend low-dose aspirin (ASA) plus hydroxychloroquine (HCQ) to ALL my systemic lupus (SLE) patients unless they have risk factors for bleeding.

I do this based upon the 2017 Italian study by Fasano et al. I explain to my patients that there are uncertainties to this recommendation and that further studies are needed. However, since cardiovascular events are among the top 2 causes of premature death in our patients, anything we can safely do to help prevent them is paramount.

To my patients who have serologic reasons for increased thrombosis (antiphospholipid antibodies as in the question or PC4d positivity), I add in my discussion that they have an even greater risk for these events than others, so doing all we can to prevent them is imp...