Antiphospholipid syndrome primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Primary Prevention
The primary prevention of antiphospholipid syndrome is as follows:[1][2][3]
- Anticoagulation in patients with risk factors for arterial and venous thrombosis.
- Minimizing the contribution of reversible risk factors for recurrent thrombosis.
- A daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies.
Patients with definite antiphospholipid syndrome and first venous event* Patients with definite antiphospholipid syndrome and recurrent events despite warfarin with a target intensity of 2·0–3·0 Patients with arterial thrombosis with single positive or low-titre antiphospholipid antibodies Secondary prophylaxis Indefinite anticoagulation to a target INR 2·0–3·0 Indefinite anticoagulation to a target INR 3·0–4·0 or alternative therapies such as extended therapeutic dose low-molecular-weight heparin As per usual recommendations for arterial thrombosis Patients with definite antiphospholipid syndrome and arterial event* Indefinite anticoagulation to a target INR 3·0–4·0 or combined antithrombotic treatment Patients with venous thromboembolism with single positive or low-titre antiphospholipid antibodies As per usual recommendations for deep vein thrombosis treatment INR=international normalised ratio. *Less aggressive or long-lasting antithrombotic treatments might be appropriate in low-risk patients.
References
- ↑ Nalli C, Andreoli L, Casu C, Tincani A (2014). "Management of recurrent thrombosis in antiphospholipid syndrome". Curr Rheumatol Rep. 16 (3): 405. doi:10.1007/s11926-013-0405-4. PMID 24449256.
- ↑ Erkan D, Lockshin MD (2004). "How much warfarin is enough in APS related thrombosis?". Thromb Res. 114 (5–6): 435–42. doi:10.1016/j.thromres.2004.06.010. PMID 15507275.
- ↑ Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR (1995). "The management of thrombosis in the antiphospholipid-antibody syndrome". N Engl J Med. 332 (15): 993–7. doi:10.1056/NEJM199504133321504. PMID 7885428.