Treatment of antiphospholipid syndrome

Massimo Radin; Irene Cecchi; Elena Rubini; Silvia Grazietta Foddai; Alice Barinotti; Elisa Menegatti; Dario Roccatello; Savino Sciascia

doi:10.1016/j.clim.2020.108597

Treatment of antiphospholipid syndrome

Clin Immunol. 2020 Dec:221:108597. doi: 10.1016/j.clim.2020.108597. Epub 2020 Sep 19.

Authors

Massimo Radin¹, Irene Cecchi², Elena Rubini², Silvia Grazietta Foddai³, Alice Barinotti³, Elisa Menegatti⁴, Dario Roccatello¹, Savino Sciascia⁵

Affiliations

¹ Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Italy; Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital, University of Turin, Italy.
² Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Italy.
³ Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Italy; School of Specialization of Clinical Pathology, Department of Clinical and Biological Sciences, University of Turin, Italy.
⁴ School of Specialization of Clinical Pathology, Department of Clinical and Biological Sciences, University of Turin, Italy.
⁵ Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Italy; Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital, University of Turin, Italy. Electronic address: savino.sciascia@unito.it.

PMID: 32961331
DOI: 10.1016/j.clim.2020.108597

Abstract

Antiphospholipid syndrome (APS) is the most common acquired thrombophilia. The clinical manifestations of APS are mainly vascular thrombosis (venous and/or arterial) and/or recurrent pregnancy morbidity with the concomitant persistent presence of antiphospholipid antibodies (aPL). Therefore, the goals of the treatment of patients with APS are reducing the pregnancy morbidity and/or the prevention of thrombotic events during the follow-up. Optimal treatment of APS has long been discussed, due to the heterogeneity of the clinical manifestations and the consequent plurality in the medical specialties involved in managing this condition. This review summarizes the available evidence on primary thromboprophylaxis in aPL-positive individuals with no prior thrombotic events, secondary prophylaxis in patients with positive history for thrombotic events, the management of refractory or difficult cases and the current strategies for the management of APS during pregnancy.

Keywords: APS; Anticoagulation; Antiphospholipid antibodies; Antiphospholipid syndrome; Immunotherapy; Pregnancy; Thrombosis; aPL.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Antiphospholipid Syndrome / drug therapy*
Humans
Thrombosis / prevention & control*