Towards evidence-based treatment of thrombotic antiphospholipid syndrome.
Thrombosis in the presence of persistently positive tests for antiphospholipid antibodies is termed thrombotic antiphospholipid syndrome (APS). At present, 'standard' secondary thromboprophylaxis in thrombotic APS is treatment with moderate intensity oral anticoagulants for life after a first venous thrombosis and with high intensity oral anticoagulation after non-embolic ischaemic stroke. These recommendations differ from those applied in the general population, where a restricted period of anticoagulation is common practice after venous thrombosis and antiplatelet drugs are the first choice after ischaemic stroke. From an extensive literature review we conclude that the available data are insufficient to apply a different strategy for secondary thromboprophylaxis in patients with thrombotic APS than the one that holds for the general population.
Derksen
R H W M
RH
Department of Rheumatology and Clinical Immunology, University Medical Centre, Utrecht, The Netherlands. r.h.derksen@azu.nl
de Groot
P G
PG
D017152:Antibodies, Antiphospholipid / Q000276:immunology; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D002545:Brain Ischemia / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods; D020521:Stroke / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors