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Can anticoagulation be withdrawn in APS patients after aPL negativization?

Maria J Cuadrado1, Angela Tincani2, Eugenia Enriquez Merayo3

  • 1Clinica Universidad de Navarra, Madrid, Spain.

Autoimmunity Reviews
|August 27, 2023
PubMed

Long-term vitamin K antagonist (VKA) anticoagulation is the cornerstone of the management of subjects with thrombotic antiphospholipid syndrome (APS). Recent investigations have opened up new discussion points regarding the potential for stopping anticoagulant medication in patients with a history of thrombotic APS who no longer have detectable aPL (the so called aPL negativization). Despite the lack of unanimous agreement, some experts agreed on defining aPL negativization as the presence of two negative determinations, 1 year apart. What to do in order to optimize the management of these subjects with thrombotic APS when aPL turn negative is still a matter of debate. In this review, we aim to summarize the main evidence highlighting the magnitude of aPL negativizing among patients with APS and the features to keep in mind when considering (or not) stopping anticoagulation.

Keywords:
Anticoagulant withdrawalAntiphospholipid antibodies negativizationAntiphospholipid syndrome

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