期刊
AUTOIMMUNITY REVIEWS
卷 13, 期 6, 页码 685-696出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.autrev.2014.01.053
关键词
Antiphospholipid syndrome; Oral direct thrombin inhibitors; Hydroxychloroquine; Statins; Complement and B-cell inhibition; Peptide therapy
类别
资金
- Versus Arthritis [19423, 19708] Funding Source: researchfish
- Arthritis Research UK [19423, 19708] Funding Source: Medline
- Versus Arthritis [19423, 19708] Funding Source: Medline
Antiphospholipid Syndrome (APS) is characterized by vascular thrombosis and/or pregnancy morbidity occurring in patients with persistent antiphospholipid antibodies (aPL). The primary objective of the APS Treatment Trends Task Force, created as part of the 14th International Congress on aPL, was to systematically review the potential future treatment strategies for aPL-positive patients. The task force chose as future clinical research directions: a) determining the necessity for controlled clinical trials in venous thromboembolism with the new oral direct thrombin or anti-factor Xa inhibitors pending the results of the ongoing rivaroxaban in APS (RAPS) trial, and designing controlled clinical trials in other forms of thrombotic APS; b) systematically analyzing the literature as well as aPL/APS registries, and creating specific registries for non-warfarin/heparin anticoagulants; c) increasing recruitment for an ongoing primary thrombosis prevention trial, and designing secondary thrombosis and pregnancy morbidity prevention trials with hydroxychloroquine; d) determining surrogate markers to select patients for statin trials; e) designing controlled studies with rituximab and other and-B-cell agents; f) designing mechanistic and clinical studies with eculizumab and other complement inhibitors; and g) chemically modifying peptide therapy to improve the half-life and minimize immunogenicity. The report also includes recommendations for clinicians who consider using these agents in difficult-to-manage aPL-positive patients. (C) 2014 Elsevier B.V. All rights reserved.
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