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Update on antiphospholipid syndrome.

Michael D Lockshin¹

¹Weill Medical College, Cornell University, USA. lockshinm@hss.edu

Bulletin of the NYU Hospital for Joint Diseases

|October 22, 2008

Summary

This summary is machine-generated.

This review covers new clinical issues and therapies for antiphospholipid antibody syndrome. It highlights complement-mediated mechanisms and recommends warfarin over aspirin for prophylaxis.

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Area of Science:

Rheumatology
Immunology
Clinical Medicine

Background:

Antiphospholipid antibody syndrome (APS) is a significant autoimmune disorder.
Recent updates to classification criteria (Sapporo 2006) have revealed new clinical manifestations.
Understanding APS pathogenesis and treatment is crucial for patient outcomes.

Purpose of the Study:

To review emerging clinical challenges in APS.
To elucidate the mechanisms of antiphospholipid antibody action.
To discuss current and novel therapeutic strategies for APS.

Main Methods:

Literature review of recent advancements in APS.
Analysis of updated classification criteria and clinical presentations.
Synthesis of evidence regarding antiphospholipid antibody mechanisms and treatment efficacy.

Main Results:

New clinical issues include cardiac, renal, and multiple sclerosis-like disease, alongside catastrophic APS.
Antiphospholipid antibody action is strongly suggested to be complement-mediated.
Moderate-dose warfarin is recommended for APS prophylaxis; aspirin is not advised for primary prophylaxis.

Conclusions:

APS diagnosis and management require awareness of evolving clinical criteria and manifestations.
Complement inhibition represents a potential therapeutic target.
Current evidence supports specific anticoagulant therapies for APS prophylaxis, necessitating careful consideration of aspirin's role.