An update on current management strategies for antiphospholipid syndrome‑related thrombosis

References

• Forastiero R, Martinuzzo M. Antigen specificity and clinical relevance of antiphospholipid syndrome‑related autoantibodies. Curr. Rheumatol. Rev. 1, 177–187 (2005).
   Google Scholar
• Wijetilleka S, Scoble T, Khamashta MA. Novel insights into pathogenesis, diagnosis and treatment of antiphospholipid syndrome. Curr. Opin. Rheumatol. 24, 473–481 (2012).
   Google Scholar
• Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J. Thromb. Haemost. 4, 295–306 (2006). ▪▪ Consensus addressing the last existing evidence on clinical manifestations and laboratory features of the antiphospholipid syndrome (APS).
   Google Scholar
• Sciascia S, Lopez‑Pedrera C, Roccatello D, Cuadrado MJ. Catastrophic antiphospholipid syndrome (CAPS). Best Pract. Res. Clin. Rheumatol. 26, 535–541 (2012). ▪▪ Review regarding current knowledge of pathogenesis, clinical manifestations, diagnosis and treatment strategies in catastrophic APS.
   Google Scholar
• Hernández‑Molina G, Espericueta‑Arriola G, Cabral AR. The role of lupus anticoagulant and triple marker positivity as risk factors for rethrombosis in patients with primary antiphospholipid síndrome. Clin. Exp. Rheumatol. 31, 382–388 (2013).
   Google Scholar
• Pengo V, Ruffatti A, Legnani C et al. Clinical course of high‑risk patients diagnosed with antiphospholipid syndrome. J. Thromb. Haemost. 8, 237–242 (2010). ▪ Prospective study addressing the clinical course of patients having triple antiphospholipid antibody positivity.
   Google Scholar
• Pengo V, Ruffatti A, Legnani C et al. Incidence of a first thromboembolic event in asymptomatic carriers of high‑risk antiphospholipid antibody profile: a multicenter prospective study. Blood 118, 4714–4718 (2011).
   Google Scholar
• Forastiero R, Martinuzzo M, Pombo G et al. A prospective study of antibodies to beta2‑glycoprotein I and prothrombin, and risk of thrombosis. J. Thromb. Haemost. 3, 1231–1238 (2005). ▪ First prospective study reporting IgG antibodies to b2 glycoprotein I antibodies and prothrombin are independent risk factors of thrombosis recurrence in patients with antiphospholipid antibodies.
   Google Scholar
• Bizzaro N, Ghirardello A, Zampieri S et al. Anti‑prothrombin antibodies predict thrombosis in patients with systemic lupus erythematosus: a 15‑year longitudinal study. J. Thromb. Haemost. 5, 1158–1164 (2007).
   Google Scholar
• Sciascia S, Murru V, Sanna G et al. Clinical accuracy for diagnosis of antiphospholipid syndrome in systemic lupus erythematosus: evaluation of 23 possible combinations of antiphospholipid antibody specificities. J. Thromb. Haemost. 10, 2512–2518 (2012).
   Google Scholar
• Galli M. Interpretation and recommended testing for antiphospholipid antibodies. Semin. Thromb. Hemost. 38, 348–352 (2012).
   Google Scholar
• Pengo V, Banzato A, Denas G et al. Correct laboratory approach to APS diagnosis and monitoring. Autoimmun. Rev. 12, 832–834 (2013).
   Google Scholar
• Pengo V, Banzato A, Bison E et al. Antiphospholipid syndrome: critical analysis of the diagnostic path. Lupus 19, 428–431 (2010).
   Google Scholar
• Keeling D, Mackie I, Moore G, Greer I, Greaves M; British Committee for Standards in Hematology. Guidelines on the investigation and management of antiphospholipid syndrome. Br. J. Haematol. 157, 47–58 (2012). ▪▪ Updated guidance on the diagnosis and management of APS patients. The Grading of Recommendations, Assessment, Development and Evaluation system was used to provide recommendations.
   Google Scholar
• Turesson C, Jacobsson LT, Matteson EL. Cardiovascular co‑morbidity in rheumatic diseases. Vasc. Health Risk Manag. 4, 605–614 (2008).
   Google Scholar
• Erkan D, Harrison MJ, Levy R et al. Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: a randomized, double‑blind, placebo‑controlled trial in asymptomatic antiphospholipid antibody‑positive individuals. Arthritis Rheum. 56, 2382–2391 (2007).
   Google Scholar
• Finazzi G. Primary antithrombotic prevention in carriers of antiphospholipid antibodies without systemic autoimmune disorders. Lupus 21, 747–750 (2012).
   Google Scholar
• Bertero M. Primary prevention in antiphospholipid carriers. Lupus 21, 751–754 (2012).
   Google Scholar
• Ruiz‑Irastorza G, Cuadrado M, Ruiz‑Arruza I et al. Evidence‑based recommendations for the prevention and long‑term management of thrombosis in antiphospholipid antibody‑positive patients: a report of a Task Force at the 13th International Congress on Antiphospholipid Antibodies. Lupus 20, 206–218 (2011).
   Google Scholar
• Arnaud L, Mathian A, Ruffatti A et al. Efficacy of aspirin for the primary prevention of thrombosis in patients with antiphospholipid antibodies: an international and collaborative meta‑analysis. Autoimmun. Rev. doi:10.1016/j.autrev.2013.10.014 (2013) (Epub ahead of print).
   Google Scholar
• Kearon C, Akl E, Comerota A et al.; American College of Chest Physicians. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence‑Based Clinical Practice Guidelines. Chest 141, S419–S494 (2012).
   Google Scholar
• Langsberg M, O´Donnell M, Kathri P et al.; American College of Chest Physicians. Antithrombotic and thrombolytic therapy for ischemic stroke: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence‑Based Clinical Practice Guidelines. Chest 141, 601S‑636S (2012).
   Google Scholar
• Finazzi G, Marchioli R, Brancaccio V et al. A randomized clinical trial of high intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J. Thromb. Haemost. 3, 848–853 (2005). ▪▪ Randomized trial demonstrating that both moderate- and high-intensity anticoagulation are comparable in preventing recurrent thrombosis in APS.
   Google Scholar
• Finazzi G, Brancaccio V, Moia M et al. Natural history and risk factors for thrombosis in 360 patients with antiphospholipid antibodies: a four year prospective study from the Italian Registry. Am. J. Med. 100, 530–536 (1996).
   Google Scholar
• Schulman S, Svenungsson E, Granqvist S. Anticardiolipin antibodies predict early recurrence of thromboembolism and death among patients with venous thromboembolism following anticoagulant therapy. Duration of Anticoagulation Study Group. Am. J. Med. 104, 332–338 (1998).
   Google Scholar
• Kasthuri RS, Roubey RA. Warfarin and the antiphospholipid syndrome: does one size fit all? Arthritis Rheum. 57, 1346–1347 (2005).
   Google Scholar
• Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR. The management of thrombosis in the antiphospholipid‑antibody syndrome. N. Engl. J. Med. 332, 993–997 (1995).
   Google Scholar
• Crowther MA, Ginsberg JS, Julian J et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N. Engl. J. Med. 349, 1133–1138 (2003). ▪▪ Randomized double-blind trial demonstrating that moderate-intensity warfarin is appropriate for patients with APS.
   Google Scholar
• Erkan D, Lockshin MD. New approaches for managing antiphospholipid syndrome. Nat. Clin. Pract. Rheumatol. 5, 160–170 (2009).
   Google Scholar
• Broder A, Putterman C. Hydroxychloroquine use is associated with lower odds of persistently positive antiphospholipid antibodies and/or lupus anticoagulant in systemic lupus erythematosus. J. Rheumatol. 40, 30–33 (2013).
   Google Scholar
• Petri M, Law G, Fang H, Magder L. Hydroxychloroquine reduces thrombosis (both arterial and venous) in systemic lupus erythematous, but only in antiphospholipid positive patients. Presented at: 14th International Congress on Antiphospholipid Antibodies. Rio de Janeiro, Brazil, 18–21 September 2013.
   Google Scholar
• Sciascia S, Giachino O, Roccatello D. Prevention of thrombosis relapse in antiphospholipid syndrome patients refractory to conventional therapy using intravenous immunoglobulin. Clin. Exp. Rheumatol. 30, 409–413 (2012).
   Google Scholar
• Schmidt‑Tanguy A, Voswinkel J, Henrion D et al. Antithrombotic effects of hydroxychloroquine in primary antiphospholipid syndrome patients. J. Thromb. Haemost. 11, 1927–1929 (2013).
   Google Scholar
• Erkan D, Vega J, Ramón G, Kozora E, Lockshin MD. A pilot open‑label Phase II trial of rituximab for non‑criteria manifestations of antiphospholipid syndrome. Arthritis Rheum. 65, 464–471 (2013).
   Google Scholar
• Ames P, Tommasino C, Fossati G, Scenna G, Brancaccio V, Ferrara F. Limited effect of rituximab on thrombocytopenia and anticardiolipin antibodies in a patient with primary antiphospholipid syndrome. Ann. Hematol. 86, 227–278 (2007).
   Google Scholar
• Rubenstein E, Arkfeld DG, Metyas S, Shinada S, Ehresmann S, Liebman HA. Rituximab treatment for resistant antiphospholipid syndrome. J. Rheumatol. 33, 355–357 (2006).
   Google Scholar
• Sciascia S, Naretto C, Rossi D, Bazzan M, Roccatello D. Treatment‑induced downregulation of antiphospholipid antibodies: effect of rituximab alone on clinical and laboratory features of antiphospholipid syndrome. Lupus 20, 1106–1108 (2011).
   Google Scholar
• Braendstrup P, Bjerrum OW, Nielsen O et al. Rituximab chimeric anti‑CD20 monoclonal antibody treatment for adult refractory idiopathic thrombocytopenic purpura. Am. J. Hematol. 78, 275–280 (2005).
   Google Scholar
• Wardlaw JM, Murray V, Berge E, Del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst. Rev. (4), CD000213 (2009).
   Google Scholar
• Okuma H, Kitagawa Y, Yasuda T, Tokuoka K, Takagi S. Comparison between single antiplatelet therapy and combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome. Int. J. Med. Sci. 7, 15–18 (2009).
   Google Scholar
• Levine SR, Brey RL, Tilley BC et al. Antiphospholipid antibodies and subsequent thrombo‑occlusive events in patients with ischemic stroke. JAMA 291, 576–584 (2004).
   Google Scholar
• Cohen H, Khamashta M, Machin S et al. Update in the RAPS (Rivaroxaban in APS) trial. Presented at: 14th International Congress on Antiphospholipid Antibodies. Rio de Janeiro, Brazil, 18–21 September 2013.
   Google Scholar
• Ruiz‑Irastorza G, Hunt B, Khamashta M. A systematic review of secondary thromboprophylaxis in patients with antiphospholipid antibodies. Arthritis Rheum. 57, 1487–1495 (2007).
   Google Scholar
• Erkan D, Pierangeli S. Could statins be a new therapeutic option for antiphospholipid syndrome patients? Expert Rev. Hematol. 6, 115–117 (2013).
   Google Scholar
• Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO; American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence‑Based Clinical Practice Guidelines. Chest 141, 691S–736S (2012).
   Google Scholar
• Cervera R. CAPS Registry. Lupus 21, 755–757 (2012).
   Google Scholar
• Agmon‑Levin N, Rosário C, Katz B et al. Ferritin in the antiphospholipid syndrome and its catastrophic variant (cAPS). Lupus 22, 1327–1335 (2013).
   Google Scholar
• Kitchens CS. Thrombotic storm: when thrombosis begets thrombosis. Am. J. Med. 104, 381–385 (1998).
   Google Scholar
• Cervera R, Bucciarelli S, Plasin M et al. Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of a series of 280 patients from the ‘CAPS Registry’. J. Autoimmun. 32, 240–245 (2009).
   Google Scholar
• Cervera R, Tektonidou M, Espinosa G et al. Task force on catastrophic antiphospholipid syndrome (APS) and non‑criteria APS manifestations (I): catastrophic APS, APS nephropathy and heart valve lesions. Lupus 20, 165–173 (2011). ▪ Consensus recommendations for the clinical management of patients with catastrophic APS.
   Google Scholar
• Bucciarelli S, Espinosa G, Cervera R et al. Mortality in the catastrophic antiphospholipid syndrome: causes of death and prognostic factors in a series of 250 patients. Arthritis Rheum. 54, 2568–2576 (2006).
   Google Scholar
• Erkan D, Asherson RA, Espinosa G et al. Long term outcome of catastrophic antiphospholilid syndrome survivors. Ann. Rheum. Dis. 62, 530–533 (2003).
   Google Scholar
• Berman H, Rodriguez‑Pintó I, Cervera R et al.; Catastrophic Antiphospholipid Syndrome (CAPS) Registry Project Group (European Forum on Antiphospholipid Antibodies). Rituximab use in the catastrophic antiphospholipid syndrome: descriptive analysis of CAPS registry patients receiving rituximab. Autoimmun. Rev. 12, 1085–1090 (2013).
   Google Scholar
• Espinosa G, Berman H, Cervera R. Management of refractory cases of catastrophic antiphospholipid syndrome. Autoimmun. Rev. 10, 664–668 (2011).
   Google Scholar