Treatment of the antiphospholipid syndrome with direct oral anticoagulantsPosition statement of German societies.
Conclusions: 1. Clinical suspicion of APS requires careful diagnostic testing. Because of inadequate diagnostic workup, many patients may not even have an APS, and these patients could be adequately treated with a DOAC. 2. Patients with single or double positive antiphospholipid antibodies but without positive LA may have a comparably low thrombotic risk and may also be treated with a DOAC in venous TE - sufficient evidence for that conclusion is not yet available but is suggested by the results of meta-analyses. 3. Triple positive patients or those with APS who suffered from arterial thromboembolism have a very high recurrence risk of thrombosis; the TRAPS-Study shows that these patients should be treated with VKA instead of a DOAC. PMID: 31621546 [PubMed - in process]
CONCLUSIONS: The limited number of the available data on this sensitive issue supports the need for further studies. Clinical follow-up of children of mothers with APS seems to be important to exclude, in the neonatal period, the occurrence of aPL associated pathological events such as thrombosis, and in the long-term, impairment in learning skills or behavioral problems. PMID: 32752918 [PubMed - as supplied by publisher]
CONCLUSION: aCL and aβ2GPI IgA are associated with clinical manifestations of APS. However, isolated IgA positivity was rare and not associated with thrombosis or pregnancy morbidity. These data do not support testing for aCL and aβ2GPI IgA subsequent to conventional aPL assays in identifying patients with thrombosis or pregnancy morbidity. PMID: 32696448 [PubMed - as supplied by publisher]
CONCLUSIONS: TSP-1 is probably implicated in the pathogenesis of APS. In vitro cell treatments along with high TSP-1 levels in plasma of APS patients suggest that high TSP-1 levels could mark a prothrombotic state and an underlying inflammatory process. PMID: 32709480 [PubMed - as supplied by publisher]
ConclusionsThe anti ‐β2GPI/HLA‐DR antibody is frequently associated with RPL. Detection of these autoantibodies is useful in understanding the pathogenesis of RPL. Our findings will potentially provide new therapeutic modalities for patients with obstetric APS.
CONCLUSIONS: Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications. PMID: 32536318 [PubMed - as supplied by publisher]
Abstract Antiphospholipid syndrome (APS) is one of the more common acquired causes of hypercoagulability. Its major presentations are thrombotic (arterial, venous or microvascular) and pregnancy morbidity (miscarriages, late intrauterine fetal demise, and severe pre-eclampsia). Classification criteria include three different antiphospholipid antibodies: lupus anticoagulant; anticardiolipin; and anti-beta 2 glycoprotein I. Management includes both preventive strategies (low dose aspirin, hydroxychloroquine) and long-term anticoagulation after thrombosis. PMID: 32413497 [PubMed - as supplied by publisher]
Antiphospholipid syndrome (APS) is one of the more common acquired causes of hypercoagulability. Its major presentations are thrombotic (arterial, venous or microvascular) and pregnancy morbidity (miscarriages, late intrauterine fetal demise, and severe pre-eclampsia). Classification criteria include three different antiphospholipid antibodies: lupus anticoagulant; anticardiolipin; and anti-beta 2 glycoprotein I. Management includes both preventive strategies (low dose aspirin, hydroxychloroquine) and long-term anticoagulation after thrombosis.
CONCLUSIONS: The combination of heparin (UFH or LMWH) plus aspirin during the course of pregnancy may increase live birth rate in women with persistent aPL when compared with aspirin treatment alone. The observed beneficial effect of heparin was driven by one large study in which LMWH plus aspirin was compared with aspirin alone. Adverse events were frequently not, or not uniformly, reported in the included studies. More research is needed in this area in order to further evaluate potential risks and benefits of this treatment strategy, especially among women with aPL and recurrent pregnancy loss, to gain consensus on the ...
Antiphospholipid syndrome (APS), an autoantibody mediated disease, is characterized by presence of antibodies against the proteins bound to the phospholipid membranes. The antibodies are predominantly formed against beta-2-glycoprotein I (b2GPI) which is considered pathogenic, but presence of lupus anticoagulant is a predictor of thrombotic events. The thrombotic events in APS may manifest as venous or arterial or small vessel thrombosis in any tissue or organ and pregnancy related complications namely, recurrent (three or more) and early spontaneous miscarriages before 10 weeks of gestation or unexplained deaths of nor...
ConclusionsTaking together, our study shows the ability of patient-derived aPL to induce immune cell activation and TF expression on monocytes. For the first time, we demonstrated the influence of anti-D1 β2GPI on the activation status of monocytes, NK and cytotoxic T cells. Our findings further support a crucial role of D1 epitope in the promotion of thrombosis and obstetrical complications in APS.