Anticoagulation therapy in the antiphospholipid syndrome: recent advances

PURPOSE OF REVIEW: The antiphospholipid syndrome is currently best treated with anticoagulation. This review discusses the recent literature addressing the duration, intensity, and appropriateness of anticoagulation or antiplatelet therapy in various clinical subcategories of this syndrome. RECENT FINDINGS: Several recent articles reaffirm the benefits of long-term anticoagulation in patients with venous thromboembolism or undergoing renal transplantation and support recommendations for usual International Normalized Ratio targets. Aspirin seems to confer benefits similar to those of anticoagulation in arterial stroke. Appropriate anticoagulation strategies for pregnancy are controversial. SUMMARY: Anticoagulation will remain the mainstay of treatment for most patients with antiphospholipid syndrome. The optimal therapy for specific subgroups of patients will, however, require further good-quality studies.