title: Prevention of Recurrent Thrombosis in Antiphospholipid Syndrome: Different from the General Population?
abstract: Antiphospholipid syndrome (APS) is characterized by arterial and/or venous thrombosis with or without pregnancy morbidity in the presence of autoantibodies targeting proteins that associate with membrane phospholipids, termed "antiphospholipid antibodies" (aPL). Management of arterial and venous thromboses shares some similarities with management of arterial and venous thromboses in the general population; however, there are key differences. The majority of studies addressing management of thrombotic APS focus on secondary prevention. Vitamin K antagonists (VKA) are typically used for secondary prevention of venous thromboembolism in APS. Optimal management of isolated arterial thrombosis, in particular ischemic stroke, in patients with APS is controversial, and proposed therapeutic options have included antiplatelet agents and VKA. Primary prophylaxis in aPL-positive patients should be an individualized decision taking into account patient-specific risks. There may be a role for adjuvant therapies such as hydroxychloroquine, vitamin D, statins, or novel therapeutics in specific patient populations.
authors.affiliation: McMaster University, 1280 Main St. West, Hamilton, Ontario, Canada, L8S 4L8. legauk2@mcmaster.ca.
authors.forename: Kimberly Janet
authors.initials: KJ
authors.lastname: Legault
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Ugarte
authors.affiliation: McMaster University, 1280 Main St. West, Hamilton, Ontario, Canada, L8S 4L8.
authors.forename: Mark Andrew
authors.initials: MA
authors.lastname: Crowther
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ruiz-Irastorza
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications*; D006801:Humans; D012008:Recurrence; D055502:Secondary Prevention; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*
keywords: Anti-β2 glycoprotein-1 antibody; Anticardiolipin antibody; Antiphospholipid antibodies; Antiphospholipid syndrome; Lupus anticoagulant; Systemic lupus erythematosus