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Pol. Arch. Med. Wewn. · Nov 2024
ReviewHow to treat patients with thrombotic antiphospholipid syndrome in 2024?
- Ciprian Jurcut, Simona Caraiola, Massimo Radin, and Savino Sciascia.
- Pol. Arch. Med. Wewn. 2024 Nov 28; 134 (11).
AbstractAntiphospholipid syndrome (APS) encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic APS in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on correcting the traditional thrombotic risk factors and, in certain situations, may include low‑dose aspirin and / or prophylactic anticoagulants (eg, low‑molecular‑weight heparin). Treatment of thrombotic APS primarily involves long‑term anticoagulation with vitamin K antagonists (VKAs). In some cases, a combination of VKAs and low‑dose aspirin, increased doses of VKAs with an international normalized ratio target greater than 3, or a switch to therapeutic doses of low‑molecular‑weight heparin might be employed. The use of hydroxychloroquine is essential in patients with secondary systemic lupus erythematosus and may be considered in individuals with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.
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