Treatment of Thrombosis in Antiphospholipid Syndrome

Abstract

Antiphospholipid syndrome (APS) is an acquired cause of venous thromboembolism (VTE), i.e., deep vein thrombosis and/or pulmonary embolism in patients with systemic lupus erythematosus or other autoimmune diseases, as well as in the general population. Antiphospholipid antibodies (aPLs), particularly lupus anticoagulant, are important thrombotic risks factors [1]. Growing evidence demonstrates that aPLs, particularly antibodies specific for β2 glycoprotein I, are not merely a marker of thrombophilia but are pathogenic, directly contributing to hypercoagulability. Current management of VTE in patients with APS does not substantially differ from that in the general population of patients with VTE and without APS. However, a more problematic monitoring of the anticoagulant treatment, both in the acute and in the long-term management, and the high risk of recurrences makes the treatment of VTE in patients with APS more challenging and deserves some special considerations. The intensity and duration of anticoagulation with vitamin K antagonists (VKA) for longer-term secondary prophylaxis are therefore important issues.