How is cryopyrin associated periodic syndrome treated Approach to the treatment of a patient who presents with cryopyrin associated periodic syndrome (CAPS) Owing to the high mortality (30%–50%) in patients who develop CAPS, every effort should be made to prevent its development. APS patients and asymptomatic patients with aPL abs must have infections (including minor …
How is cryopyrin associated periodic syndrome treated Read More »
Role of DOACs in APS treatment What are direct oral anticoagulants (DOACs) and what is their role in APS treatment? DOACs are non-vitamin K antagonist oral anticoagulants that bind directly to specific clotting factors. Dabigatran is a factor IIa inhibitor, whereas rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors. They have a rapid onset of …
Approach for the treatment of APS patients who have a recurrent clot while receiving anticoagulation If an APS patient has a clot while on anticoagulation, it is imperative to establish that the patient was adequately anticoagulated at the time of the recurrent thrombosis. The APS patient on warfarin should have an INR of 2 to …
Treatment of APS patients who have a recurrent clot while receiving anticoagulation Read More »
Best treatment for the pregnant patient with elevated Antiphospholipid Antibodies What is the best treatment for the pregnant patient with elevated aPL abs who has had previous fetal loss but no previous history of thrombosis? How about if they have a previous history of thrombosis? ASA (81–100 mg) daily is prescribed before conception. Once conception …
Best treatment for the pregnant patient with elevated Antiphospholipid Antibodies Read More »
What is the treatment for a patient who had a noncerebral arterial thrombosis and elevated levels of Antiphospholipid Antibodies? • If a patient is at medium risk for recurrence (no LA, no prior clot, no cardiovascular risk factors, no SLE) and/or at high bleeding risk, then treatment can be combination antiplatelet agents (ASA [81 mg daily] …
What is the treatment for a patient who has had a venous thrombosis and elevated levels of aPL abs (secondary venous thrombosis prevention)? Two prospective trials ( N Engl J Med 349:1133, 2003; J Thromb Haemost 3:848, 2005) have shown that after initial heparin therapy transitioning to moderate intensity warfarin therapy (INR: 2 to 3) is sufficient to prevent …
What parenteral anticoagulants are available to treat a patient with APS who has a history of HIT? • Direct thrombin (IIa) inhibitor. • Argatroban. • Treatment of clot dose: 2 μg/kg/min IV. • Monitor: PTT. Follow chromogenic factor X when transitioning to warfarin. • Use cautiously with dose adjustment in liver insufficiency. • Synthetic pentasaccharide (inhibits factor Xa via antithrombin similar …