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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
PubMed

Insights

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

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.

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