What are the Potential Future Treatments in Antiphospholipid Syndrome?

  • Doruk Erkan
  • Anisur Rahman
  • Hannah Cohen
  • Samuel J. Machin
  • Silvia S. Pierangeli
Chapter

Abstract

Persistently positive antiphospholipid antibodies (aPL) in association with thromboses and/or pregnancy morbidity is the hallmark of the antiphospholipid syndrome (APS). The management of aPL-positive patients has been focused on utilizing traditional antithrombotic medications, such as heparin or warfarin. Given that our understanding of the molecular mechanisms of aPL-mediated thrombosis has been growing, this chapter reviews potential “immunomodulatory” approaches (tissue factor inhibition, P38 mitogen-activated protein kinase inhibition, nuclear factor-κB inhibition, platelet glycoprotein receptor inhibition, hydroxychloroquine, statins, inhibition of b2-glycoprotein-I β2GPI and/or anti-β2 GPI binding to target cells, complement inhibition, and B cell inhibition) as well as new oral thrombin and factor Xa inhibitors that will most likely have an important future role in the management of aPL-positive patients.

Keywords

Heparin Psoriasis Thrombocytopenia Statin Simvastatin 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Doruk Erkan
    • 1
  • Anisur Rahman
    • 2
  • Hannah Cohen
    • 3
  • Samuel J. Machin
    • 4
  • Silvia S. Pierangeli
    • 5
  1. 1.The Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special SurgeryWeill Cornell Medical College of Cornell UniversityNew YorkUSA
  2. 2.Centre for RheumatologyUniversity College LondonLondonUK
  3. 3.Department of HaematologyUniversity College London Hospitals, NHS Foundation TrustLondonUK
  4. 4.Department of HaematologyUniversity College London HospitalsLondonUK
  5. 5.Division of Rheumatology, Department of Internal Medicine, Microbiology and PathologyUniversity of Texas Medical BranchGalvestonUSA

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