Antiphospholipid syndrome (APS): treatment

Evidence-based neurology checklist on antiphospholipid syndrome (aps): treatment: Main treatments of APS Asymptomatic: low dose aspirin Venous thrombosis: Warfarin with a target INR of 2.5-3 Arterial thrombosis: Warfarin with a target INR of ≥3 Recurrent thrombosis: Warfarin and Aspirin…

Main treatments of APS

  • Asymptomatic: low dose aspirin
  • Venous thrombosis: Warfarin with a target INR of 2.5-3
  • Arterial thrombosis: Warfarin with a target INR of ≥3
  • Recurrent thrombosis: Warfarin and Aspirin
  • Rivaroxaban is riskier and less effective than Warfarin

Additional treatment of resistant thrombosis: in addition to Warfarin at ≥3

Treatment in pregnancy

References

  1. Sanna G, Bertolaccini ML, Cuadrado MJ, Khamashta MA, Hughes GRV. Central nervous system involvement in the antiphospholipid (Hughes) syndrome. Rheumatology 2003; 42: 200-213.
  2. Keeling D, Mackie I, Moore GW, et al. Guidelines on the investigation and management of antiphospholipid syndrome. Br J Haematol 2012; 157:47-58.
  3. Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood 2018; 132:1365-1371. 
  4. Stanescu C, Andronesi AG, Jurcut C, et al. Successful treatment of catastrophic antiphospholipid syndrome using rituximab: case report and review of the literature. Medicina (Kaunas) 2021; 57:912.
  5. Lockshin MD. Update on antiphospholipid syndrome. Bull NYU Hosp Jt Dis 2006; 64:57-59.

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