Thromboprophylaxis and obstetric management of the antiphospholipid syndrome

Expert Opin Pharmacother. 2009 Mar;10(4):601-14. doi: 10.1517/14656560902772302.

Abstract

There is consensus in treating patients with antiphospholipid syndrome (APS) and first venous thrombosis with oral anticoagulation to a target international normalized ratio of 2.0 - 3.0. A recent systematic review recommended a target international normalized ratio > 3.0 in the group of patients with APS and arterial thrombosis. The approach for women with obstetric manifestations of APS is based on the use of aspirin plus heparin. In addition, we summarize the evidence-based information about management of catastrophic APS and some difficult cases, such as 'seronegative' APS, patients who do not display formal classification criteria for APS, and recurrent thrombotic events despite optimal anticoagulation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / drug therapy*
  • Antiphospholipid Syndrome / physiopathology
  • Aspirin / therapeutic use*
  • Catastrophic Illness
  • Drug Therapy, Combination
  • Female
  • Heparin / therapeutic use*
  • Humans
  • Obstetrics / methods
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy*
  • Pregnancy Complications, Hematologic / etiology
  • Pregnancy Complications, Hematologic / physiopathology
  • Venous Thrombosis / etiology
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / prevention & control*
  • Young Adult

Substances

  • Anticoagulants
  • Heparin
  • Aspirin