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Treatment of neurologic complications of antiphospholipid antibody syndrome
1Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7883, USA.
Insights
Antiphospholipid antibody (aPL) syndrome can cause dangerous blood clots in arteries and veins, especially stroke. Current treatments focus on antithrombotics and immune modulation, but more research is needed to determine the best prevention strategies.
Area of Science:
- Medical Science
- Immunology
- Neurology
Background:
- Antiphospholipid antibodies (aPL) are associated with thrombosis in both venous and arterial systems.
- Cerebral infarction is the most frequent arterial thrombo-occlusive event in patients with aPL.
- Current treatment strategies for cerebrovascular disease in aPL patients require further investigation.
Purpose of the Study:
- To review current treatment strategies for patients with cerebrovascular disease and antiphospholipid antibodies (aPL).
- To discuss primary and secondary prevention methods for thrombo-occlusive events in aPL patients.
- To highlight the need for prospective studies to evaluate standardized therapies.
Main Methods:
- Review of existing literature on thrombosis associated with antiphospholipid antibodies.
- Discussion of general treatment issues, primary prevention, and secondary prevention strategies.
- Identification of the need for prospective studies to compare different therapeutic regimens.
Main Results:
- Thrombosis in aPL patients affects both venous and arterial circulation, with cerebral infarction being common.
- Treatment regimens often involve antithrombotics or immune modulation.
- Evidence-based recommendations for specific therapies are limited due to a lack of prospective studies.
Conclusions:
- Standardized therapies are needed to effectively manage and prevent recurrent thrombo-occlusive events in aPL patients.
- Prospective studies are crucial to determine the efficacy of different treatment strategies.
- Further research is required to establish evidence-based guidelines for managing cerebrovascular disease in the context of aPL.
Abstract:
Thrombosis associated with antiphospholipid antibodies (aPL) occurs in both venous and the arterial circulation. The most common arterial thrombo-occlusive event is cerebral infarction. We briefly review treatment strategies aimed at patients with cerebrovascular disease and aPL. Besides general treatment issues, we discuss primary prevention and secondary prevention. Most regimens include antithrombotics or immune modulation. Prospective studies (currently underway) are required to better estimate the rate of recurrent thrombo-occlusive events on standardized therapy before one therapy can be recommended over another with reasonable evidence.