[Management of antiphospholipid syndrome].

The prevention of thrombosis in the antiphospholipid syndrome (APS) remains controversial. The purpose of this review is to provide updated recommendations. There is evidence that patients at risk of thrombosis are those with "a pattern of high risk antiphospholipid antibodies (aPL)" (presence of a lupus anticoagulant [LA], association of several aPL, or persistent aCL at a medium or high level), or those with associated systemic lupus erythematosus (SLE). The prescription of aspirin in primary prevention is recommended in SLE patients with positive LA or persistent aCL at a significant level. Secondary prevention is based on a very prolonged anticoagulation. An INR around 2.5 seems to be sufficient in patients with venous APS. In case of arterial events, the attitude is debated. We propose to maintain a target INR between 3 and 3.5. The possible occurrence of relapse despite anticoagulation in the therapeutic target may lead to the addition of aspirin. The development of new anti-thrombotic agents might change the management of APS in the coming years.
AuthorsD Saadoun, J-C Piette, D Wahl, N Costedoat-Chalumeau
JournalLa Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne (Rev Med Interne) Vol. 33 Issue 4 Pg. 217-22 (Apr 2012) ISSN: 1768-3122 [Electronic] France
Vernacular TitleTraitement du syndrome des anticorps antiphospholipides.
PMID22360832 (Publication Type: English Abstract, Journal Article, Review)
CopyrightCopyright © 2012 Société nationale Française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Antiphospholipid
  • Biomarkers
  • Immunologic Factors
  • Aspirin
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Antibodies, Antiphospholipid (blood)
  • Antiphospholipid Syndrome (complications, drug therapy, immunology)
  • Aspirin (therapeutic use)
  • Biomarkers (blood)
  • Evidence-Based Medicine
  • Humans
  • Immunologic Factors (blood)
  • Lupus Erythematosus, Systemic (complications, drug therapy, immunology)
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Thrombosis (immunology, prevention & control)
  • Treatment Outcome

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