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Thrombotic antiphospholipid syndrome: From guidelines to clinical management.
- Source :
-
Medicina clinica [Med Clin (Barc)] 2024 Aug; Vol. 163 Suppl 1, pp. S22-S30. - Publication Year :
- 2024
-
Abstract
- Thrombotic manifestations, mainly venous thromboembolism (VTE) and stroke, are the most common and potentially life-threatening presentations of antiphospholipid syndrome (APS). The management of APS requires the assessment of the antiphospholipid antibodies (aPL) profile, of concurrent systemic lupus erythematosus or other systemic autoimmune diseases and the presence of risk factors for cardiovascular disease and bleeding. Anticoagulation with vitamin K antagonists (VKA) remains the cornerstone of therapy for thrombotic APS. As platelets play a central role in APS, low-dose aspirin is the first option for primary thromboprophylaxis in asymptomatic aPL carriers, and also plays a role as combination therapy with VKAs in arterial thrombosis. Treatment with direct oral anticoagulants (DOACs) could be considered in certain low-risk situations, although they are not recommended in patients with arterial thrombosis or triple positive aPL. Adjuvant therapies such as hydroxychloroquine and statins may be useful in complex settings such as thrombotic recurrences or high risk of bleeding. In this article, we review the evidence and the recommendations of the guidelines for the treatment of APS, and provide a critical and practical approach of its management from our clinical perspective.<br /> (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- Humans
Thrombosis etiology
Thrombosis prevention & control
Venous Thromboembolism etiology
Venous Thromboembolism prevention & control
Antibodies, Antiphospholipid blood
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Risk Factors
Antiphospholipid Syndrome complications
Antiphospholipid Syndrome diagnosis
Antiphospholipid Syndrome drug therapy
Practice Guidelines as Topic
Anticoagulants therapeutic use
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1578-8989
- Volume :
- 163 Suppl 1
- Database :
- MEDLINE
- Journal :
- Medicina clinica
- Publication Type :
- Academic Journal
- Accession number :
- 39174150
- Full Text :
- https://doi.org/10.1016/j.medcli.2024.02.010