title: Thrombotic Management of Antiphospholipid Syndrome: Towards Novel Targeted Therapies.
abstract: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in APS patients. However, although APS has been reported for more than 30 years, there has been no optimal regimen for its prevention or for the management of thrombosis, mainly because the mainstay treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology. Instead, the treatments commonly used are aimed at general thrombotic disorders. Warfarin is the most commonly used vitamin K antagonist (VKA), in addition to anti-platelet medications, such as aspirin and clopidogrel. Over the last decade, novel non-VKA oral anticoagulants, including rivaroxaban, apixaban and dabigatran, as well as immunomodulatory agents, such as rituximab, eculizumab, hydroxychloroquine, statins and sirolimus, have also been used. In this review, we discuss the current treatment strategies and future treatment outlook for thrombotic APS.
authors.affiliation: Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan. Malaysia.
authors.forename: Md Asiful
authors.initials: MA
authors.lastname: Islam
authors.affiliation: Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan. Malaysia.
authors.forename: Fahmida
authors.initials: F
authors.lastname: Alam
authors.affiliation: Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan. Malaysia.
authors.forename: Kah Keng
authors.initials: KK
authors.lastname: Wong
authors.affiliation: King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah. Saudi Arabia.
authors.forename: Mohammad Amjad
authors.initials: MA
authors.lastname: Kamal
authors.affiliation: Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan. Malaysia.
authors.forename: Siew Hua
authors.initials: SH
authors.lastname: Gan
mesh_terms: D000818:Animals; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Antiphospholipid syndrome; anti-platelet agents; anticoagulant; antiphospholipid antibodies; thrombosis; treatment