Antiphospholipid antibody syndrome: treatment

Of the many clinical manifestations seen in the antiphospholipid antibody syndrome (APAS), two deserve major therapeutic consideration: recurrent fetal loss and vascular thromboses. Treatment of these two major complications remain empirical, although recent studies appear to indicate the beneficial use of multiple therapeutic options including low dose aspirin, alone or in combination with a moderate amount of prednisone, heparin and intravenous gammaglobulin for the prevention of fetal loss, and longterm anticoagulation with maintenance of an international normalized ratio (INR) of 3 to 4 as an effective measure in the prevention of vascular thrombosis. The use of interleukin-3 in animal models of the syndrome has been shown to be effective in the prevention of fetal loss, and this therapeutic modality appears promising, particularly because of its recognized low frequency of side effects in therapeutic trials in humans.