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Treatment of antiphospholipid syndrome beyond anticoagulation

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Dobrowolski C1, Erkan D2. Clin Immunol. 2018 Mar 3. pii: S1521-6616(18)30119-0. doi: 10.1016/j.clim.2018.03.001. [Epub ahead of print]

Abstract

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1 Department of Medicine, University of Ottawa, Ontario, Canada.

2 Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, USA. Electronic address: erkand@hss.edu.

Abstract

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder marked by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPL). At the present time, treatment is primarily focused on anticoagulation. However, there is increasing awareness of the mechanisms involved in APS pathogenesis, which has led to the trial of novel therapies targeting those mechanisms. Following a brief review of the etiopathogenesis of and current management strategies in APS, this paper focuses on the evidence for these potential, targeted APS treatments, e.g., hydroxychloroquine, statins, rituximab, belimumab, eculizumab, defibrotide, sirolimus, and peptide therapy.