Related Experiment Video
Updated: Aug 24, 2025
10:37
Ferric Chloride-induced Murine Thrombosis Models
Published on: September 5, 2016
21.9K
Emerging Therapies in Antiphospholipid Syndrome
1Department of Cardiovascular and Metabolic Sciences, Taussig Cancer Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Transfusion Medicine Reviews
|October 22, 2022
Summary
Antiphospholipid syndrome (APS) treatments like hydroxychloroquine and rituximab show promise for managing symptoms and enhancing anticoagulation. Complement inhibition, particularly eculizumab, is effective for catastrophic APS and may benefit other forms.
Area of Science:
- Immunology
- Hematology
- Rheumatology
Background:
- Antiphospholipid syndrome (APS) is a leading cause of acquired immune-mediated thrombophilia, characterized by thrombosis or pregnancy complications with antiphospholipid antibodies.
- Despite over 50 years of recognition, the underlying pathogenesis of APS remains unclear, limiting mechanism-based therapies.
- Current APS management involves long-term anticoagulation or aspirin and heparin for obstetric issues, highlighting the need for novel treatments.
Approach:
- This review critically examines clinical studies of immunomodulatory agents, including hydroxychloroquine, rituximab, and eculizumab (a complement C5 inhibitor).
- The focus is on evaluating the efficacy and potential mechanisms of these agents in managing APS manifestations.
- The review synthesizes current evidence, acknowledging the limitations of small study sizes.
Key Points:
- Hydroxychloroquine may improve the effectiveness of vitamin K antagonists in APS patients.
- Rituximab shows potential in alleviating "non-criteria" manifestations of APS.
- Eculizumab is effective in catastrophic APS (CAPS), suggesting a significant role for complement activation.
Conclusions:
- While conclusions are qualified due to small study sizes, hydroxychloroquine and rituximab offer potential therapeutic benefits in APS.
- Eculizumab's efficacy in CAPS underscores the importance of the complement system in severe APS.
- Further research is needed to elucidate complement's role in non-catastrophic APS, with emerging data suggesting complement inhibition's potential for thrombosis prevention.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
18
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
18
01:27Peripheral Artery Disease III: Interprofessional Care
20
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
20
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
612
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
612
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
849
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
849
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
247
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
247
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
32
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
32