Description

More than 15 years has elapsed since the detailed clinical description of the antiphospholipid syndrome. The extensive manifestations mean that virtually any physician may encounter patients with this potentially treatable condition. Because of limited controlled, prospective data, current therapy remains empirical. There is now good evidence that patients with antiphospholipid-associated thrombosis will be subject to recurrences and require prophylactic therapy. Although most authorities agree that warfarin may prevent recurrences of venous and arterial thrombosis, there is still debate about the intensity and duration of warfarin therapy. Steroids and immunosuppressive drugs have not provided longterm benefit. Controlled clinical trials of the treatment of pregnant women with antiphospholipid antibody demonstrated that prednisolone is ineffective,
and possibly detrimental in treatment of recurrent pregnancy loss, and that heparin plus low-dose aspirin is beneficial.