TY - JOUR
T1 - Thrombotic management of antiphospholipid syndrome
T2 - Towards novel targeted therapies
AU - Islam, Md Asiful
AU - Alam, Fahmida
AU - Wong, Kah Keng
AU - Kamal, Mohammad Amjad
AU - Gan, Siew Hua
N1 - Funding Information:
We would like to acknowledge the Universiti Sains Malaysia (USM) Vice-Chancellor Award (2015/2016) and the USM Global Fellowship (2014/2015) awarded to Md. Asiful Islam and Fahmida Alam, respectively, to pursue their PhD degrees.
Publisher Copyright:
© 2017, Bentham Science Publishers.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017
Y1 - 2017
N2 - Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in APS patients. However, although APS has been reported for more than 30 years, there has been no optimal regimen for its prevention or for the management of thrombosis, mainly because the mainstay treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology. Instead, the treatments commonly used are aimed at general thrombotic disorders. Warfarin is the most commonly used vitamin K antagonist (VKA), in addition to anti-platelet medications, such as aspirin and clopidogrel. Over the last decade, novel non-VKA oral anticoagulants, including rivaroxaban, apixaban and dabigatran, as well as immunomodulatory agents, such as rituximab, eculizumab, hydroxychloroquine, statins and sirolimus, have also been used. In this review, we discuss the current treatment strategies and future treatment outlook for thrombotic APS.
AB - Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in APS patients. However, although APS has been reported for more than 30 years, there has been no optimal regimen for its prevention or for the management of thrombosis, mainly because the mainstay treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology. Instead, the treatments commonly used are aimed at general thrombotic disorders. Warfarin is the most commonly used vitamin K antagonist (VKA), in addition to anti-platelet medications, such as aspirin and clopidogrel. Over the last decade, novel non-VKA oral anticoagulants, including rivaroxaban, apixaban and dabigatran, as well as immunomodulatory agents, such as rituximab, eculizumab, hydroxychloroquine, statins and sirolimus, have also been used. In this review, we discuss the current treatment strategies and future treatment outlook for thrombotic APS.
KW - Anti-platelet agents
KW - Anticoagulant
KW - Antiphospholipid antibodies
KW - Antiphospholipid syndrome
KW - Thrombosis
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85025440249&partnerID=8YFLogxK
U2 - 10.2174/1570161115666170105120931
DO - 10.2174/1570161115666170105120931
M3 - Review Article
C2 - 28056758
AN - SCOPUS:85025440249
SN - 1570-1611
VL - 15
SP - 313
EP - 326
JO - Current Vascular Pharmacology
JF - Current Vascular Pharmacology
IS - 4
ER -