Antiphospholipid Syndrome (Antiphospholipid Antibody Syndrome)

The presence of antibodies directed against phospholipids (ANTIBODIES, ANTIPHOSPHOLIPID). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (ANTIBODIES, ANTICARDIOLIPIN). Present also are high levels of lupus anticoagulant (LUPUS COAGULATION INHIBITOR).

Also Known As:

Networked: 3487 relevant articles (57 outcomes, 235 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Systemic Lupus Erythematosus (Libman-Sacks Disease)
2.	Thrombosis (Thrombus)
3.	Stroke (Strokes)
4.	Thrombocytopenia (Thrombopenia)
5.	Venous Thrombosis (Deep-Vein Thrombosis)

Experts

1.	Shoenfeld, Yehuda: 57 articles (10/2015 - 01/2002)
2.	Shoenfeld, Y: 56 articles (11/2013 - 01/2000)
3.	Cervera, Ricard: 44 articles (10/2015 - 12/2002)
4.	Atsumi, Tatsuya: 34 articles (11/2015 - 02/2002)
5.	Khamashta, Munther A: 31 articles (12/2014 - 05/2002)
6.	Ruffatti, A: 30 articles (07/2015 - 01/2000)
7.	Koike, Takao: 28 articles (01/2013 - 01/2002)
8.	Meroni, Pier Luigi: 27 articles (05/2015 - 07/2002)
9.	Tincani, A: 27 articles (05/2014 - 12/2000)
10.	Khamashta, M A: 27 articles (12/2012 - 01/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Antiphospholipid Syndrome:

1.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 01/01/1997 - "Our results suggest that primary antiphospholipid syndrome appears to be improved by low-dose aspirin treatment, with a high rate of neonatal survival (95%). " 10/01/2000 - "This preliminary study suggests that low-dose aspirin has no additional benefit when added to supportive care for women for whom recurrent early fetal loss is the only sequela of the antiphospholipid syndrome. " 01/01/1997 - "The aim of this study was to determine the neonatal outcome in women with well-characterized antiphospholipid syndrome treated during pregnancy with low-dose aspirin. " 11/01/2013 - "Desensitisation to aspirin in antiphospholipid antibody syndrome." 06/01/2013 - "Six years earlier, antiphospholipid syndrome was diagnosed and treated with aspirin. "
2.	Heparin (Liquaemin)FDA LinkGeneric 06/01/2015 - "There is agreement regarding the use of heparin in the prevention of gestational complications in patients with antiphospholipid syndrome, while its use for other obstetrical complications is under debate. " 12/01/2011 - "Strategies for managing heparin therapy in patients with antiphospholipid antibody syndrome." 10/01/2010 - "Heparin treatment in antiphospholipid syndrome with recurrent pregnancy loss." 06/01/2010 - "Heparin treatment in antiphospholipid syndrome with recurrent pregnancy loss: a systematic review and meta-analysis." 03/01/2010 - "Monitoring plasma heparin concentration in a patient with antiphospholipid syndrome."
3.	Warfarin (Coumadin)FDA LinkGeneric 02/01/2006 - "Many of these issues, such as warfarin failure or resistance, the optimal warfarin initiation dose, the optimal target International Normalized Ratio in antiphospholipid syndrome, the optimal monitoring frequency and use of point-of-care monitoring, the management of oral anticoagulation during invasive procedures, and the management of over-anticoagulation, have not been evaluated in rigorously-designed clinical trials. " 09/01/1996 - "Provisional Steering Committee of the Warfarin in Antiphospholipid Syndrome (WAPS) Study." 05/01/1995 - "We suggest that in patients with culture-negative endocardial vegetations, specific tests should be performed for the primary antiphospholipid syndrome and a therapeutic trial of warfarin should be undertaken before contemplating heart surgery." 03/01/2015 - "Discussion about the intensity of warfarin in patients with antiphospholipid syndrome (APS) remains present in our days. " 01/01/2014 - "Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. "
4.	Intravenous Immunoglobulins (IVIG)FDA Link 12/01/2005 - "Using the same approach, we prepared anti-anti-beta-2-glycoprotein-I (beta2GPI) specific IVIg for antiphospholipid syndrome (APS). " 01/01/2004 - "Fifteen women with a history of three previous RPL between 6 and 22 weeks of gestation and positivity for the antiphospholipid antibody syndrome (APS) were randomized to one of two treatment groups: (a) an intravenous immunoglobulin therapy group (RPL-IVIg; 7 patients), 500 mg IVIg/kg/month and (b) a placebo-treated group given multivitamins (8 patients). " 05/01/2000 - "[Therapeutic use of intravenous immunoglobulins in the antiphospholipid syndrome]." 01/01/2000 - "A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. " 01/01/1999 - "[Value of intravenous immunoglobulins during antiphospholipid syndrome]."
5.	rituximab (Mabthera)FDA Link 02/01/2010 - "Controlled clinical trials are needed to determine if rituximab is effective in the antiphospholipid syndrome." 12/01/2008 - "Clinical improvement in antiphospholipid syndrome after rituximab therapy." 02/01/2013 - "A pilot open-label phase II trial of rituximab for non-criteria manifestations of antiphospholipid syndrome." 02/02/2015 - "[Efficacy and safety of rituximab in the treatment of primary antiphospholipid syndrome: analysis of 24 cases from the bibliography review]." 02/02/2015 - "[Rituximab in antiphospholipid syndrome: always, never, sometimes?]."
6.	Antiphospholipid AntibodiesIBA 10/01/2015 - "The aim of the study was to examine an extended panel of antiphospholipid antibodies in Ssc patients who did not have any clinical features of antiphospholipid antibody syndrome. " 11/01/2013 - "Antiphospholipid Syndrome Alliance For Clinical Trials and International Networking (APS ACTION) is an international research network devoted to conducting well-designed clinical trials in persistently antiphospholipid antibody (aPL)–positive patients. " 10/01/2013 - "Since other immunological disorders might affect the results, antiphospholipid antibodies (APA), which are the markers of antiphospholipid antibody syndrome, were also screened in all women prior to study. " 05/01/2013 - "Antiphospholipid antibodies (aPL) seem to induce a prothrombotic state by activating endothelium and platelets, but no studies have evaluated systematically the effects of aPL from patients with the antiphospholipid syndrome (APS) in quiescent versus catastrophic phase. " 06/01/2012 - "AntiPhospholipid Syndrome Alliance For Clinical Trials and InternatiOnal Networking (APS ACTION) is the first-ever international research network that has been created specifically to design and conduct well-designed, large-scale, multi-center clinical trials in persistently antiphospholipid antibody (aPL)-positive patients. "
7.	Anticardiolipin AntibodiesIBA 09/01/2004 - "In this study we sought to assess (1) the diagnostic value of a combined search for anti-beta(2)-glycoprotein (abeta(2)-GPIs) and anticardiolipin antibodies (aCLs) in primary (APS I) and secondary (APS II) antiphospholipid syndrome and (2) the influence of the beta(2)-GPI preparation in the ELISA's results. " 03/01/2003 - "To test the feasibility of applying a mimetic (specific for a patient-derived prothrombotic anticardiolipin antibody [aCL]) to study the homologous, disease-associated aCL in patients with antiphospholipid syndrome (APS). " 05/01/2000 - "Eleven patients with antiphospholipid syndrome (study group) and 11 healthy controls, matched by maternal and gestational age (control group) were prospectively examined for the presence of anticardiolipin antibodies in the cord blood during labour, and amniotic fluid during vaginal or Caesarean delivery. " 05/01/2000 - "The aim of this study was to investigate whether, in patients with antiphospholipid syndrome, anticardiolipin antibodies pass from mother to offspring sera and amniotic fluid. " 06/01/1995 - "To study whether monoclonal anticardiolipin antibodies (aCL), derived from patients with antiphospholipid syndrome (APS), have similar pathogenic potential, we have employed an experimental model of antiphospholipid syndrome. "
8.	Lupus Coagulation Inhibitor (Lupus Anticoagulant)IBA 01/01/2015 - "Variability in the international normalised ratio (INR) in patients with antiphospholipid syndrome and positive lupus anticoagulant: should the INR targets be higher?" 05/01/2013 - "The role of lupus anticoagulant and triple marker positivity as risk factors for rethrombosis in patients with primary antiphospholipid syndrome." 02/01/2013 - "Phospholipid-dependent coagulation tests for lupus anticoagulant (LA) are considered an important step for the diagnosis of anti-phospholipid syndrome; however, LA laboratory detection is difficult because of many variables. " 01/01/2013 - "Investigations revealed a positive lupus anticoagulant and she was given a presumptive diagnosis of catastrophic antiphospholipid syndrome (CAPS). " 06/01/2011 - "The latter more often correlate with clinical manifestations of antiphospholipid syndrome and with lupus anticoagulant activity. "
9.	AnticoagulantsIBA 01/01/2005 - "In spite of the improvement in our knowledge on the pathogenic mechanisms of the antiphospholipid syndrome, the standard therapy is still based on anti-platelet or anticoagulant drugs, both for vascular and obstetrical problems. " 12/01/2015 - "Anticoagulants have to be used in the management of antiphospholipid syndrome. " 01/01/2015 - "[New oral anticoagulants in antiphospholipid syndrome]." 12/01/2014 - "In the antiphospholipid syndrome, many news: better characterization of the severe disease, involvement of the mTOR pathway in the vasculopathy-induced renal disease, and diversification of the therapeutic approaches: use of mTOR inhibitors and several biologics, new various antiplatelet and anticoagulants. " 11/01/2014 - "[Seronegative antiphospholipid syndrome, catastrophic syndrome, new anticoagulants: learning from a difficult case report]."
10.	eculizumabFDA Link 09/01/2015 - "Eculizumab Induces Sustained Remission in a Patient With Refractory Primary Catastrophic Antiphospholipid Syndrome." 11/01/2014 - "Efficacy of eculizumab in a patient with immunoadsorption-dependent catastrophic antiphospholipid syndrome: a case report." 01/01/2014 - "36-year-old female with catastrophic antiphospholipid syndrome treated with eculizumab: a case report and review of literature." 02/01/2014 - "Eculizumab prevents recurrent antiphospholipid antibody syndrome and enables successful renal transplantation." 08/15/2014 - "A case of thrombotic microangiopathy associated with antiphospholipid antibody syndrome successfully treated with eculizumab."

Therapies and Procedures

1.	Plasmapheresis 01/01/2015 - "Response to Plasmapheresis Measured by Angiogenic Factors in a Woman with Antiphospholipid Syndrome in Pregnancy." 11/01/2008 - "The research showed the positive effect of the combined therapy strategy of plasmapheresis and ultraviolet irradiation of blood: pregnant women with antiphospholipid syndrome in 42% cases delivered mature fetus." 12/01/2007 - "Plasmapheresis and pregnancy outcome in patients with antiphospholipid syndrome." 06/01/2003 - "Combined plasmapheresis and immunosuppression as rescue treatment of a patient with catastrophic antiphospholipid syndrome occurring despite anticoagulation: a case report." 12/01/1999 - "Pulmonary capillaritis associated with the antiphospholipid antibody syndrome and rapid response to plasmapheresis."
2.	Plasma Exchange 04/01/2009 - "Case reports of the use of immunoadsorption or plasma exchange in high-risk pregnancies of women with antiphospholipid syndrome." 02/01/2009 - "Recovery from catastrophic antiphospholipid syndrome by a plasma exchange procedure: report of four cases and review of the literature." 08/01/2008 - "Plasma exchange for the management of the catastrophic antiphospholipid syndrome: importance of the type of fluid replacement." 01/01/2007 - "A second-line treatment protocol including plasma exchange (PE) in addition to the standard therapies was scheduled and utilized in our hospital with the intent of improving the outcome of high risk pregnancies of women with primary antiphospholipid syndrome (APS). " 01/01/2007 - "Plasma exchange in the management of high risk pregnant patients with primary antiphospholipid syndrome. "
3.	Transplantation (Transplant Recipients) 09/01/2010 - "During the study period, 37 patients had APA (2.7%), primarily LA, and 12 fulfilled antiphospholipid syndrome (APS) diagnostic criteria (0.8%) at the time of transplantation. " 01/01/2014 - "Although plasmapheresis is partially effective for antibody removal, the optimal treatment allowing successful transplantation in patients with antiphospholipid syndrome has not been established. " 06/01/2008 - "To our knowledge this is the first reported case of severe acute heart failure due to anti-phospholipid antibody syndrome in which the patient survived through assist device placement and successful transplantation." 06/01/2008 - "Acute myocardial infarction requiring mechanical bridge to transplantation in a patient with undiagnosed anti-phospholipid antibody syndrome." 11/01/2002 - "Following transplantation, primary anti-phospholipid antibody syndrome was diagnosed after a thromboembolic event and continued dyspnea. "
4.	Hormone Replacement Therapy (Therapy, Hormone Replacement) 10/01/2001 - "Generally accepted or "classically" acquired risk factors for venous thromboembolism include advanced age, prolonged immobilisation, surgery, fractures, use of oral contraceptives and hormone replacement therapy, pregnancy, puerperium, cancer and antiphospholipid syndrome. " 02/20/1993 - "The 1st patient had repeated episodes of thrombosis on a background of altered general condition; he was examined by computed tomography (CT) which showed enlarged and presumably tumoral adrenal glands; adrenal insufficiency was present and improved under hormone replacement therapy; the thrombotic episodes were attributed to the antiphospholipid antibodies; after a 5-year follow-up the antiphospholipid syndrome remained alone, and further examinations showed progressive adrenal atrophy. " 11/01/2001 - "The following order may be proposed: risk factors which cannot be changed: age (which remains the principal factor) and gender (women being at higher risk than men); true acquired risk factors such as cancer, dysimmune conditions (more specifically, the antiphospholipid syndrome) and hormone replacement therapy (oestroprogestative contraception which has been updated by the debate about "third generation pills" and the risk related to progesterone-like substances themselves; hormone replacement therapy of the menopause which still has no clinical trials to assess "our" forms with natural hormones administered transdermally or transmucosally). "
5.	Drug Therapy (Chemotherapy) 03/01/2014 - "Three cases due to chemotherapy, antiphospholipid syndrome and acute pancreatitis are reported." 11/01/2012 - "Of the cases, 12 (16.22%) had antiphospholipid syndrome (APS); 16 patients (21.62%) had a history of previous abdominal/pelvic surgery, which might have been contributing to delay of conception; 66 patients (89.18%) were on drug therapy by corticosteroids, colchicines and other agents. " 11/01/2005 - "Remission of severe antiphospholipid syndrome associated with non-Hodgkin's B-cell lymphoma after combined treatment with rituximab and chemotherapy." 09/01/2006 - "Prednisolone was administered for nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia, and 6 courses of chemotherapy with 70Gy radio-therapy were performed. " 08/01/2009 - "Recently, increased incidence of venous thrombosis following thalidomide use has been reported in the treatment of diseases with disease-related thrombotic risks, such as malignancy and lupus with antiphospholipid antibody syndrome, as well as concomitant therapy with chemotherapy and/or systemic corticosteroids. "