Is there a role for immunosuppression in antiphospholipid syndrome?

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy morbidity, or nonthrombotic manifestations in patients with persistently positive antiphospholipid antibodies (aPL). Conventional APS treatment focuses on antithrombotic strategies, which are usu...

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Bibliographic Details
Published in:Hematology 2019-12, Vol.2019 (1), p.426-432
Main Authors: Sevim, Ecem, Willis, Rohan, Erkan, Doruk
Format: Article
Language:English
Subjects:
New Diagnostic and Treatment Strategies for Antiphospholipid Syndrome
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Summary:Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy morbidity, or nonthrombotic manifestations in patients with persistently positive antiphospholipid antibodies (aPL). Conventional APS treatment focuses on antithrombotic strategies, which are usually ineffective for the microvascular and nonthrombotic manifestations of aPL. Using a case-based presentation, this review focuses on the role of immunosuppression in nonobstetric APS, including B-cell inhibition (rituximab, belimumab, and bortezomib), complement inhibition (eculizumab), mechanistic target of rapamycin inhibition (sirolimus), vascular endothelial cell modulation (defibrotide), statins, and traditional rheumatologic disease-modifying agents (hydroxychloroquine, mycophenolate mofetil, azathioprine, and cyclophosphamide).
ISSN:1520-4391
1520-4383
1520-4383
DOI:10.1182/hematology.2019000073