Antiphospholipid syndrome primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

The primary prevention of antiphospholipid syndrome is anticoagulation with low-dose aspirin or warfarin in patients with risk factors for arterial and venous thrombosis, daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies, minimizing the contribution of reversible risk factors for recurrent thrombosis and use of statins in patients with hyperlipidemia.

Primary Prevention

The primary prevention of antiphospholipid syndrome is as follows:^[1]^[2]^[3]

Anticoagulation with low-dose aspirin or warfarin in patients with risk factors for arterial and venous thrombosis.
Minimizing the contribution of reversible risk factors for recurrent thrombosis.
A daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies.
Use of statins in patients with hyperlipidemia.

Primary thromboprophylaxis
Condition	Comment
Patients with systemic lupus erythematosus and lupus anticoagulant and/or persistently positive anticardiolipin	Hydroxychloroquine and consider low-dose aspirin
Patients with obstetric antiphospholipid syndrome	Low-dose aspirin or no therapy
Asymptomatic carriers of antiphospholipid antibodies	No therapy or low dose aspirin
All patients with antiphospholipid antibodies	Strict control of vascular risk factors
High-risk situations (surgery, post partum, long-lasting immobilisation)	Adequate thromboprophylaxis

References

↑ Nalli C, Andreoli L, Casu C, Tincani A (2014). “Management of recurrent thrombosis in antiphospholipid syndrome”. Curr Rheumatol Rep. 16 (3): 405. doi:10.1007/s11926-013-0405-4. PMID 24449256.
↑ Erkan D, Lockshin MD (2004). “How much warfarin is enough in APS related thrombosis?”. Thromb Res. 114 (5–6): 435–42. doi:10.1016/j.thromres.2004.06.010. PMID 15507275.
↑ Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR (1995). “The management of thrombosis in the antiphospholipid-antibody syndrome”. N Engl J Med. 332 (15): 993–7. doi:10.1056/NEJM199504133321504. PMID 7885428.

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[pmid24449256-1] Nalli C, Andreoli L, Casu C, Tincani A (2014). “Management of recurrent thrombosis in antiphospholipid syndrome”. Curr Rheumatol Rep. 16 (3): 405. doi:10.1007/s11926-013-0405-4. PMID 24449256.

[pmid15507275-2] Erkan D, Lockshin MD (2004). “How much warfarin is enough in APS related thrombosis?”. Thromb Res. 114 (5–6): 435–42. doi:10.1016/j.thromres.2004.06.010. PMID 15507275.

[pmid7885428-3] Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GR (1995). “The management of thrombosis in the antiphospholipid-antibody syndrome”. N Engl J Med. 332 (15): 993–7. doi:10.1056/NEJM199504133321504. PMID 7885428.

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