Morbidity and mortality in the antiphospholipid syndrome

Abstract

Patients with APS develop significant morbidity and mortality despite current therapy.

Chemical synthesis and characterization of wild‐type and biotinylated N‐terminal domain 1–64 of β2‐glycoprotein I

“…6,22 To date, the only treatment proven to reduce the risk of thrombosis in APS is life-long anticoagulation, which often has severe side effects. 3 Despite antithrombotic therapy, a significant proportion of patients with APS undergo rethrombosis, 41 likely because anticoagulant therapy affects only the final outcome, without interfering with the early biochemical events from which thrombotic events originate, that is production of anti-b2GpI Abs and binding to b2GpI. 19,22,42 Hence, the possibility to identify a molecule that is able to block anti-b2GpI Abs activities could disclose new therapeutic strategies in APS.…”

Thrombotic risk assessment in the antiphospholipid syndrome requires more than the quantification of lupus anticoagulants

“…Yet the thrombogenicity assessment in patients with APS is still hampered by laboratory tests with poor predictive value for the thrombotic phenotype. 1,3 One of the drawbacks of the current classic coagulation tests for identifying the presence or absence of LACs is that they provide only information about the presence of aPL antibodies but not the concentration of antibodies, complicating a correct assessment of LAC levels and their evolution. LACs may be falsely positive, especially if identified as of "mild potency," found in elderly patients or if diagnosed for the first time.…”

“…2 Because rates of morbidity and mortality are high in the APS, awareness of the need for optimal prognostic markers in the prediction of complications of the APS is growing. 3 The laboratory diagnosis assigns patients with a common event (thrombosis) to a group with a high risk of recurrence, a prerequisite for long-term oral anticoagulant therapy. Assays for the detection of aPL antibodies, therefore, must be sufficiently sensitive to identify patients correctly as being APS positive.…”

Inhibition of the mTORC Pathway in the Antiphospholipid Syndrome

“…1 The syndrome may be isolated or may occur in association with autoimmune disorders, such as systemic lupus erythematosus. Thrombotic events represent the major complication of the antiphospholipid syndrome, 2 and to date, long-term anticoagulation has been the only treatment shown to reduce vascular complications. However, that regimen does not prevent organ deterioration and death in highrisk patients, particularly those in whom catastrophic antiphospholipid syndrome develops.…”