New Treatments

Abstract

Vascular thrombosis and pregnancy morbidity represent the peculiar clinical manifestations of the antiphospholipid syndrome (APS), serologically characterized by the positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, available treatments present several pitfalls such as the strong impact on the quality of life of patients, the high rate of recurrences, and the bleeding risk. Novel therapeutic strategies include drugs implementing the anticoagulant and antiplatelet effect of standard treatment: new oral and nonoral anticoagulants, hydroxychloroquine, and statins. In addition, the therapeutic approach could consist in molecules modulating the interaction of aPL with molecular targets and their cellular effects: modulation of B cell and complement activation, receptor antagonism, and inhibition of aPL-induced intracellular and extracellular mediators. In this chapter, cutting-the-edge therapeutic strategies are discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS based on the recent advances in understanding of aPL pathogenic mechanisms.