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Prophylaxis of the antiphospholipid syndrome: a consensus report
D Alarcón-Segovia1, M C Boffa, W Branch
1Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico DF, Mexico. das@innsz.mx
Lupus
|August 2, 2003
Summary
Experts recommend low-dose aspirin for antiphospholipid syndrome (APS) prophylaxis, with alternatives for allergies. Anticoagulation is advised for high-risk cases, but corticosteroids and immunosuppressants are not recommended for APS prevention.
Area of Science:
- Rheumatology
- Cardiology
- Obstetrics
Background:
- Antiphospholipid syndrome (APS) necessitates prophylactic strategies for primary and secondary prevention.
- Expert consensus is crucial for defining optimal prophylactic interventions in APS management.
Framework:
- The First International Consensus on Treatment of the Antiphospholipid Syndrome guided the recommendations.
- Panel of experts evaluated hypothetical scenarios for APS prophylaxis.
Implementation:
- Low-dose aspirin is the consensus choice for prophylaxis, with antiplatelet alternatives for aspirin-allergic individuals.
- General antithrombotic and vasoprotective measures are essential.
- Anticoagulation (coumadin or low molecular weight heparin) is indicated for high-risk fetal loss or thrombosis.
Implications:
- Prophylaxis for APS should be integrated into the management of systemic lupus erythematosus patients.
- Corticosteroids and immunosuppressants are contraindicated for APS prophylaxis.