Paulien G de Jong

Publications (2)8.74 Total impact

• Source

  Available from: Michiel Coppens

  Article: Duration of anticoagulant therapy for venous thromboembolism: balancing benefits and harms on the long term.

  Paulien G de Jong, Michiel Coppens, Saskia Middeldorp
  [show abstract] [hide abstract]
  ABSTRACT: Venous thromboembolism (VTE) is effectively treated with anticoagulant therapy. After an initial treatment phase, extended treatment is effective to prevent recurrence after a first event but this is at the expense of a continued risk of bleeding. Ideally, patients at a high risk of recurrence and low risk of bleeding continue anticoagulant therapy, and for those at low risk of recurrence the duration of treatment can be limited. Identifying these patients, however, is difficult. Duration of treatment after a first VTE provoked by a transient risk factor should be limited to 3 months. Although guidelines suggest extended treatment for all patients after unprovoked VTE unless bleeding risk is high, we emphasize that the long-term risks of recurrent VTE off anticoagulation are uncertain whereas the risk of bleeding associated with anticoagulant therapy increases with age. In the absence of evidence of replaced mortality or improved quality of life with extended anticoagulant treatment, we suggest a limited duration for most patients after a first VTE. Extended treatment can be considered, based mainly on patient preference.
  British Journal of Haematology 06/2012; 158(4):433-41. · 4.94 Impact Factor
• Source

  Available from: Mariette Goddijn

  Article: Testing for inherited thrombophilia in recurrent miscarriage.

  Paulien G de Jong, Mariëtte Goddijn, Saskia Middeldorp
  [show abstract] [hide abstract]
  ABSTRACT: Approximately 1-5% of women trying to conceive experience recurrent miscarriage, and in 50% of these women, the cause of the preceding miscarriages is unknown. Inherited thrombophilias such as factor V Leiden mutation, prothrombin gene mutation (PT 20210A), and deficiencies of natural anticoagulants protein C, protein S, and antithrombin are associated with recurrent miscarriage. Knowledge of the association between inherited thrombophilia and recurrent miscarriage and of potential treatment options for improving chances of a live birth could tempt physicians to test for inherited thrombophilia in women with recurrent miscarriage. However, the strength of the association between inherited thrombophilia and recurrent miscarriage is not very strong, and more importantly, no evidence indicates that the use of anticoagulants improves the chance of live birth in these women. With the current state of evidence, testing for inherited thrombophilia should not lead to altered clinical management and therefore, should not be performed routinely in women with recurrent miscarriage but only in the context of scientific studies.
  Seminars in Reproductive Medicine 11/2011; 29(6):540-7. · 3.80 Impact Factor