Antiphospholipid syndrome (APS): treatment
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Antiphospholipid syndrome (APS): treatment. Asymptomatic: low dose aspirin. Fully referenced neurology checklist.
Main treatments of APS
- Asymptomatic: low dose aspirin
- Venous thrombosis: Warfarin with a target INR of 2.5-3
- Arterial thrombosis: Warfarin with a target INR of ≥3
- Recurrent thrombosis: Warfarin and Aspirin
- Rivaroxaban is riskier and less effective than Warfarin
Additional treatment of resistant thrombosis: in addition to Warfarin at ≥3
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Treatment in pregnancy
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References
- Sanna G, Bertolaccini ML, Cuadrado MJ, Khamashta MA, Hughes GRV. Central nervous system involvement in the antiphospholipid (Hughes) syndrome. Rheumatology 2003; 42: 200-213.
- Keeling D, Mackie I, Moore GW, et al. Guidelines on the investigation and management of antiphospholipid syndrome. Br J Haematol 2012; 157:47-58.
- Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood 2018; 132:1365-1371.
- Stanescu C, Andronesi AG, Jurcut C, et al. Successful treatment of catastrophic antiphospholipid syndrome using rituximab: case report and review of the literature. Medicina (Kaunas) 2021; 57:912.
- Lockshin MD. Update on antiphospholipid syndrome. Bull NYU Hosp Jt Dis 2006; 64:57-59.
Related checklists
- Antiphospholipid syndrome (APS): neurological features
- Antiphospholipid syndrome (APS): systemic features
- Catastrophic antiphospholipid syndrome (CAPS)
- Antiphospholipid syndrome (APS): differential diagnosis
- Antiphospholipid syndrome (APS): diagnostic criteria
- Antiphospholipid syndrome (APS): investigations
