What is the treatment for antiphospholipid syndrome (APLS) associated with CNS lupus?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Treatment of the antiphospholipid syndrome (APLS) remains controversial, with therapy based predominantly on anecdotal experience. Although many authorities recommend full anticoagulation with warfarin (Coumadin) (despite there being no randomized clinical trial to prove this), other authorities support antiplatelet therapy initially, with stronger measures reserved for repeated stroke, progressive myelopathy, or other clear-cut, clinical treatment failure.

It is clear that aiming for an international normalized ratio (INR) of 2.0–3.0 is as good at reducing the risk of further events as more intensive anticoagulation. [50] This could be done possibly in conjunction with immunosuppressant therapy to suppress production of the antibody.


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