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Treatment

There is no cure for antiphospholipid syndrome. The goals of treatment are to prevent blood clots from forming, resolve those that do and to minimise tissue and organ damage. Those who have antiphospholipid antibodies but have never had a thrombotic episode or miscarriage are not typically treated. They may never be diagnosed with APS or have associated symptoms or complications.

Those with APS should minimise other factors that increase clotting risk, such as smoking and the use of oral contraceptives. If someone has a co-existing autoimmune disorder, this condition must be managed as well.

Anticoagulants such as warfarin and heparin are typically used to treat existing blood clots. To prevent recurrence, long-term anticoagulation with warfarin or low-dose aspirin is often necessary.

Women with APS can have successful pregnancies but they and their unborn baby must be carefully monitored. Warfarin cannot be used in pregnancy as it harms the developing baby. Many people may be given heparin injections beneath the skin (subcutaneous) and low-dose aspirin during pregnancy to help minimise the potential for fetal loss.

For patients with catastrophic APS, a combination of anticoagulant, glucocorticoid and plasma exchange treatment with or without intravenous immune globulin is required. Cyclophosphamide and rituximab have been used in addition.

Additional treatments may be required to address thrombocytopenia and other APS complications.


Last Review Date: June 14, 2019