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Anticoagulant Therapy in Patients with Antiphospholipid Syndrome
Marco Capecchi1,2, Maria Abbattista3, Alessandro Ciavarella2,3
1Division of Hematology, Clinica Moncucco, 6900 Lugano, Switzerland.
Journal of Clinical Medicine
|December 11, 2022
Summary
Antiphospholipid syndrome (APS) management requires personalized anticoagulant therapy. This review explores APS, focusing on optimizing treatment and risk stratification for thrombosis and obstetrical complications, especially with direct oral anticoagulants.
Area of Science:
- Rheumatology
- Hematology
- Immunology
Background:
- Antiphospholipid syndrome (APS) is an autoimmune disorder.
- Characterized by antiphospholipid antibodies (aPLA), thrombosis, and obstetrical issues.
- aPLA alone are insufficient for thrombosis; a 'second hit' is hypothesized.
Purpose of the Study:
- To review the epidemiology, pathophysiology, and management of APS complications.
- To focus on the role of direct oral anticoagulants (DOACs) in APS treatment.
- To address challenges in anticoagulant therapy intensity and prophylaxis decisions.
Main Methods:
- Literature review of APS epidemiology and pathophysiology.
- Analysis of current treatment strategies for APS-related thrombosis.
- Evaluation of diagnostic and risk stratification tools for APS.
Main Results:
- Optimal anticoagulant intensity in APS remains undefined.
- Risk stratification tools for thrombosis in aPLA-positive patients are lacking.
- The central pathway for APS thrombosis is unknown, necessitating individualized treatment.
Conclusions:
- Personalized evaluation of clinical and laboratory features is crucial for APS management.
- Further research is needed to guide optimal anticoagulant selection and intensity.
- DOACs represent a key area of focus for future APS treatment strategies.
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