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Thrombosis and Anti-phospholipid Syndrome: a 5-Year Update on Treatment

  • Cecilia Beatrice ChighizolaEmail author
  • Pier Luigi Meroni
Systemic Lupus Erythematosus (G Tsokos, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Systemic Lupus Erythematosus

Abstract

Purpose of Review

The aim of this review is to provide an update of the therapeutic tools for thrombotic anti-phospholipid syndrome (APS), focusing on the last 5 years.

Recent Findings

Early studies appointed anticoagulation at moderate intensity as the mainstay of treatment of thrombotic APS; in the last 5 years, the strategy has not much mutated. Some uncertainties regarding the role of direct oral anticoagulants and the optimal regimen for arterial thrombotic APS still persist: high-intensity anticoagulation, anticoagulation plus anti-platelet agent, and double anti-platelet agents being the possible alternatives. Several drugs have been proposed as effective additional tools for the management of thrombotic APS: hydroxychloroquine, statins, vitamin D, and sirolimus might be beneficial when added on the top of anticoagulation. Pregnant women with thrombotic APS should be switched to low-dose aspirin plus low molecular weight heparin at therapeutic dose. Despite adequate treatment, APS patients display a significant rate of recurrences; rituximab, eculizumab, and intravenous immunoglobulins are among the options to be considered for these patients.

Summary

From 2013 to date, the kaleidoscope of therapeutic options in thrombotic APS has been enriched, but tangible improvements in the management of patients are still awaited.

Keywords

Anti-phospholipid antibodies Anti-phospholipid syndrome Thrombosis Treatment Update 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Cecilia Beatrice Chighizola
    • 1
    • 2
    • 3
    Email author
  • Pier Luigi Meroni
    • 2
  1. 1.Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
  2. 2.Experimental Laboratory of Immunological and Rheumatologic ResearchesIRCCS Istituto Auxologico ItalianoCusano MilaninoItaly
  3. 3.Unit of Immunology, Allergology and RheumatologyIRCCS Istituto Auxologico ItalianoMilanItaly

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