Antiaggregant and anticoagulant therapy in systemic lupus erythematosus and Hughes' syndrome

Antiaggregant and anticoagulant drugs are essential in the management of th e manifestations due to antiphospholipid syndrome (APS) in patients with pr imary Hughes' syndrome or systemic lupus erythematosus. Coumadin derivative s (warfarin and acenocumarol), heparin and aspirin are used for secondary t hromboprophylaxis and treatment of recurrent miscarriage. The available evi dence for each indication is reviewed in this paper. There is still debate regarding the optimal intensity of oral anticoagulation, the best drug comb ination for pregnancy failure in APS and the management of asymptomatic pat ients with antiphospholipid antibodies.