Antiphospholipid syndrome: from pathogenesis to novel immunomodulatory therapies

Antiphospholipid syndrome (APS) is characterized by recurrent thrombosis and pregnancy morbidity in association with the persistent presence of circulating antiphospholipid antibodies (aPL). APS remains the most frequent cause of acquired hypercoagulability and recurrent miscarriage. Long-term anticoagulation therapy is the only treatment with proven benefit in the APS. Anticoagulation is not effective in all patients and carries a risk of bleeding. Recent improvements in the understanding of the pathogenic mechanisms have led to the identification of potential targets and future therapies for APS. In contrast to non-specific anticoagulation, the emergence of immunomodulatory drugs provides the possibility of interfering with specific pathogenic pathways. Novel therapies might be used in the future for APS.