Therapy for thrombosis usually consists of heparin, followed by warfarin. The optimal duration of treatment is not known: some experts believe that anticoagulation can be discontinued if the antiphospholipid antibody titers decrease, but lifelong treatment is recommended for patients with recurrent disease. Associated autoimmune disorders are often treated with such drugs as hydroxychloroquine to help reduce risk of APS complications. Treatment of pregnant patients remains controversial; it may include some combination of heparin or low-molecular-weight heparin and aspirin, as warfarin is teratogenic. Patients with antiphospholipid antibodies without a history of thrombosis may benefit from prophylactic aspirin. The use of autologous stem cell transplantation or rituximab has been investigated, but the benefits remain questionable.
Meroni PL, Chighizola CB, Rovelli F, Gerosa M. Antiphospholipid syndrome in 2014: more clinical manifestations, novel pathogenic players and emerging biomarkers. Arthritis Res Ther. 2014;16(2):209.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.