title: Recognition and management of antiphospholipid syndrome.
abstract: OBJECTIVE
  This article summarizes the recent developments in the recognition and management of antiphospholipid syndrome (APS).
  
  
  RESULTS
  Five Task Forces, created as part of the 14th International Congress on antiphospholipid antibodies (aPL), published their systematic reviews. 'For the recognition of APS': the assessment of aPL profile is crucial for risk stratification; lupus anticoagulant positivity, especially in the context of 'triple aPL positivity' displays the highest risk; a panel of criteria and noncriteria aPL tests may help better risk-stratify the aPL-positive in the future. 'For the management of APS': direct oral anticoagulants are not currently recommended; statins ameliorate the proinflammator/thrombotic markers, whereas hydroxychloroquine reduces the risk of thrombosis in experimental models and lupus patients, which justify their use as an adjunctive treatment in refractory cases; B-cell inhibition may have a role in difficult-to-treat patients with hematologic and microthrombotic/angiopathic manifestations; and complement and mammalian targets of rapamycin complex pathway inhibition are promising targets in APS.
  
  
  CONCLUSIONS
  Warfarin, heparin, and/or antiplatelet drugs are the standard of care for aPL-positive patients. Recent studies suggest novel approaches that target new coagulation and immunomodulatory pathways; mechanistic and/or controlled clinical studies are needed to determine the effectiveness of these novel approaches.
authors.affiliation: aDepartment of Clinical Sciences and Community Health, Division of Rheumatology, Ospedale Gaetano Pini, University of Milan bLaboratory of Immuno-rheumatology, Istituto Auxologico Italiano, Milan, Italy cBarbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Gerosa
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Meroni
authors.forename: Doruk
authors.initials: D
authors.lastname: Erkan
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D000069283:Rituximab / Q000627:therapeutic use; D020123:Sirolimus / Q000627:therapeutic use; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D006852:Hydrochlorothiazide; D000069283:Rituximab; C481642:eculizumab; D020123:Sirolimus