New and upcoming treatments in antiphospholipid syndrome: A comprehensive review

Pharmacol Res. 2018 Jul:133:108-120. doi: 10.1016/j.phrs.2018.04.012. Epub 2018 Apr 30.

Abstract

Current therapeutic recommendations for thrombosis prevention in patients with antiphospholipid syndrome (APS) are limited to anticoagulation with vitamin K antagonists (VKA) or heparins and to anti-platelet aggregating agents. Maintaining optimized anticoagulation to prevent recurrent thrombosis or bleeding remains a therapeutic challenge. Although there are important ongoing trials with direct oral anticoagulants, they still aim the same target. New insights about pathophysiology in APS have revealed a myriad of potential pathways to be investigated as treatment targets. A radical shift from a hematological/coagulative approach to an immunological one will probably represent the near future of APS treatment. We reviewed the therapeutic trends and potential future treatments.

Keywords: Antiphospholipid antibodies; Antiphospholipid syndrome; Direct oral anticoagulants; Hydroxychloroquine; Systemic lupus erythematosus; Treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticoagulants / therapeutic use*
  • Antiphospholipid Syndrome / drug therapy*
  • Antiphospholipid Syndrome / immunology
  • Antiphospholipid Syndrome / metabolism
  • Biological Products / therapeutic use*
  • Dendritic Cells / immunology
  • Humans
  • Peptides / therapeutic use*
  • Receptors, Cell Surface / metabolism
  • TOR Serine-Threonine Kinases / metabolism

Substances

  • Anticoagulants
  • Biological Products
  • Peptides
  • Receptors, Cell Surface
  • TOR Serine-Threonine Kinases