What are the potential future treatments in antiphospholipid syndrome?

Abstract

Persistently positive antiphospholipid antibodies (aPL) in association with thromboses and/or pregnancy morbidity is the hallmark of the antiphospholipid syndrome (APS). The management of aPL-positive patients has been focused on utilizing traditional antithrombotic medications, such as heparin or warfarin. Given that our understanding of the molecular mechanisms of aPL-mediated thrombosis has been growing, this chapter reviews potential “immunomodulatory” approaches (tissue factor inhibition, P38 mitogen-activated protein kinase inhibition, nuclear factor-κB inhibition, platelet glycoprotein receptor inhibition, hydroxychloroquine, statins, inhibition of b2-glycoprotein-I β2GPI and/or anti-β2 GPI binding to target cells, complement inhibition, and B cell inhibition) as well as new oral thrombin and factor Xa inhibitors that will most likely have an important future role in the management of aPL-positive patients.