MANAGEMENT OF THE ANTIPHOSPHOLIPID SYNDROME - MAIN TRENDS, UNSOLVED QUESTIONS, PRACTICAL AND EDUCATIONAL-ASPECTS

Therapeutic guidelines are progressively emerging in the antiphospholi pid syndrome (APS). For primary APS, prevention of recurrent miscarria ges is frequently achieved by a combination of heparin plus aspirin. S teroids should not be used in the absence of associated systemic lupus erythematosus. Long term warfarin aimed at an INR of 3-3.5 is effecti ve for the secondary prevention of thrombosis. However, some doubt is raising regarding the pertinence of INR monitoring in patients with a lupus anticoagulant. Education is an important part of the management of patients with APS. Coincident risk factors for thrombosis have to b e suppressed or controlled. Psychological aspects also need to be rare ly considered during the course of this chronic disorder.