RT Journal Article
T1 Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion?
A1 Sciascia, S
A1 Coloma-Bazan, E
A1 Radin, M
A1 Bertolaccini, M L
A1 Lopez-Pedrera, C
A1 Espinosa, Gerard
A1 Meroni, P L
A1 Cervera, R
A1 Cuadrado, M J
K1 Anticoagulation
K1 Antiphospholipid antibodies
K1 Antiphosphospholipid syndrome
K1 Thrombosis
AB The current mainstay of treatment in patients with thrombotic antiphospholipid syndrome (APS) is long-term anticoagulation, mainly with Vitamin K antagonist agents. Some recently available studies have created new ground for discussion about the possible discontinuation of anticoagulation therapy in patients with a history of thrombotic APS in whom antiphospholipid antibodies (aPL) are not detected any longer (i.e. aPL seroconversion). We report the main points discussed at the last CORA Meeting regarding the issue whether or not anticoagulation can be stopped after aPL seroconversion. In particular, we systematically reviewed the available evidence investigating the clinical outcome of APS patients with aPL seroconversion in whom anticoagulation was stopped when compared to those in whom therapy was continued regardless the aPL profile. Furthermore, the molecular basis for the aPL pathogenicity, the available evidence of non-criteria aPL and their association with thrombosis are addressed. To date, available evidence is still limited to support the indication to stop oral anticoagulation therapy in patients with a previous diagnosis of thrombotic APS who subsequently developed a negative aPL profile. The identification of the whole risk profile for cardiovascular manifestations and possibly of a second level aPL testing in selected patients with aPL might support the eventual clinical decision but further investigation is warranted.
PB Elsevier
YR 2017
FD 2017-07-27
LK http://hdl.handle.net/10668/11574
UL http://hdl.handle.net/10668/11574
LA en
NO Sciascia S, Coloma-Bazán E, Radin M, Bertolaccini ML, López-Pedrera C, Espinosa G, et al. Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion? Autoimmun Rev. 2017 Nov;16(11):1109-1114
DS RISalud
RD Apr 5, 2025