Therapeutic Aspects in Antiphospholipid Syndrome

The antiphospholipid syndrome (APS) is characterised clinically by venous or arterial thrombosis and pregnancy complications and serologically by the detection of antiphospholipid antibodies (aPL) or a lupus anticoagulant (LA). In recent years, it has become evident that the risk of (further) thromboembolic and obstetric complications is significantly increased if all three serological criteria are present: antibodies against cardiolipin (aCL), antibodies against beta 2-glycoprotein-1 (a beta 2-GP1), and a positive lupus anticoagulant - a constellation called triple positivity. Low-dose aspirin (LDA), heparin and vitamin K antagonists are the mainstays of treatment. The use of direct oral anticoagulants in APS is not recommended. Immunosuppression is not effective in preventing further thromboembolic manifestations of APS.