Clinical Management of Thrombotic Antiphospholipid Syndrome

Thrombotic manifestations of antiphospholipid syndrome are often a therapeutic dilemma and challenge. Despite our increasing knowledge of this relatively new disease, many issues remain widely unknown and controversial. In this review, we summarise the latest literature and guidelines on the management of thrombotic antiphospholipid syndrome. These include the laboratory assays involved in antiphospholipid antibodies (aPL) testing, the use of direct oral anticoagulants in secondary prevention, management of recurrent thrombosis, individuals with isolated aPL, and catastrophic antiphospholipid syndrome. Treatment aims to prevent the potentially fatal and often disabling complications of APS with antithrombotic and cardiovascular risks prevention strategies. Some insights and updates on topical issues in APS are provided. We also include our current practice, which we believe is the pragmatic approach based on the currently available evidence.

Automated summary

Thrombotic manifestations of antiphospholipid syndrome pose challenges in treatment. This review summarizes the latest literature and guidelines on the management of thrombotic APS, including laboratory assays, the use of direct oral anticoagulants, management of recurrent thrombosis, isolated aPL cases, and catastrophic APS. The goal of treatment is to prevent fatal complications of APS and reduce cardiovascular risks, and this review provides insights and updates on topical issues in APS.