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ISRN Rheumatology
Volume 2014 (2014), Article ID 348726, 13 pages
http://dx.doi.org/10.1155/2014/348726
Review Article

Review on Effectiveness of Primary Prophylaxis in aPLs with and without Risk Factors for Thrombosis: Efficacy and Safety

1King Abdullah Medical Complex-Jeddah (KAMCJ), Al-Ameer Nayef Street, North Obhur, P.O. Box 55659, Jeddah 21544, Saudi Arabia
2Department of Medicine, Rheumatology Section, Hamad Medical Corporation, P.O. Box 3050, Off Al Rayyan Road, Opposite Lulu Center, Doha, Qatar

Received 9 January 2014; Accepted 10 February 2014; Published 17 April 2014

Academic Editors: E. F. Borba, P. A. Gatenby, and T. Kawakami

Copyright © 2014 Nahid A. Qushmaq and Samar A. Al-Emadi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. R. A. Asherson, R. Cervera, J. C. Piette, et al., “The antiphospholipid syndrome: history, definition, classification, and differential diagnosis,” in The Antiphospholipid Syndrome, R. A. Asherton, R. Cervera, J. C. Piette, et al., Eds., pp. 3–12, CRC Press, Boca Raton, Fla, USA, 1996.
  2. W. A. Wilson, A. E. Gharavi, T. Koike et al., “International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop,” Arthritis and Rheumatology, vol. 42, no. 7, pp. 1309–1311, 1999. View at Publisher · View at Google Scholar
  3. D. Erkan and M. D. Lockshin, “New approaches for managing antiphospholipid syndrome,” Nature Clinical Practice Rheumatology, vol. 5, no. 3, pp. 160–170, 2009. View at Publisher · View at Google Scholar · View at Scopus
  4. J. S. Levine, W. Branch, and J. Rauch, “The antiphospholipid syndrome,” The New England Journal of Medicine, vol. 346, no. 10, pp. 752–763, 2002. View at Publisher · View at Google Scholar · View at Scopus
  5. G. Bordin, R. Boldorini, and P. L. Meroni, “The two hit hypothesis in the antiphospholipid syndrome: acute ischaemic heart involvement after valvular replacement despite anticoagulation in a patient with secondary APS,” Lupus, vol. 12, no. 11, pp. 851–853, 2003. View at Publisher · View at Google Scholar · View at Scopus
  6. P. L. Meroni and P. Riboldi, “Pathogenic mechanisms mediating antiphospholipid syndrome,” Current Opinion in Rheumatology, vol. 13, no. 5, pp. 377–382, 2001. View at Publisher · View at Google Scholar · View at Scopus
  7. M. Barbhaiya and D. Erkan, “Primary thrombosis prophylaxis in antiphospholipid antibody-positive patients: where do we stand?” Current Rheumatology Reports, vol. 13, no. 1, pp. 59–69, 2011. View at Publisher · View at Google Scholar · View at Scopus
  8. M. Galli and T. Barbui, “Antiphospholipid antibodies and thrombosis: strength of association,” Hematology Journal, vol. 4, no. 3, pp. 180–186, 2003. View at Publisher · View at Google Scholar · View at Scopus
  9. C. Drenkard, A. R. Villa, D. Alarcon-Segovia, and M. E. Perez-Vazquez, “Influence of the antiphospholipid syndrome in the survival of patients with systemic lupus erythematosus,” Journal of Rheumatology, vol. 21, no. 6, pp. 1067–1072, 1994. View at Scopus
  10. D. Erkan, Y. Yazici, M. G. Peterson, L. Sammaritano, and M. D. Lockshin, “A cross-sectional study of clinical thrombotic risk factors and preventive treatments in antiphospholipid syndrome,” Rheumatology, vol. 41, no. 8, pp. 924–929, 2002. View at Scopus
  11. T. P. Greco, A. M. Conti-Kelly, E. Matsuura et al., “Antiphospholipid antibodies in patients with coronary artery disease: new cardiac risk factors?” Annals of the New York Academy of Sciences, vol. 1108, pp. 466–474, 2007. View at Publisher · View at Google Scholar · View at Scopus
  12. C. Neville, J. Rauch, J. Kassis et al., “Thromboembolic risk in patients with high titre anticardiolipin and multiple antiphospholipid antibodies,” Thrombosis and Haemostasis, vol. 90, no. 1, pp. 108–115, 2003. View at Scopus
  13. A. Ruffatti, T. Del Ross, M. Ciprian et al., “Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study,” Annals of the Rheumatic Diseases, vol. 68, no. 3, pp. 397–399, 2009. View at Publisher · View at Google Scholar · View at Scopus
  14. I. Marai, M. Shechter, P. Langevitz et al., “Anti-cardiolipin antibodies and endothelial function in patients with coronary artery disease,” The American Journal of Cardiology, vol. 101, no. 8, pp. 1094–1097, 2008. View at Publisher · View at Google Scholar · View at Scopus
  15. C. Cooper, E. Choy, J. Camilleri et al., “The blossoming of evidence-based clinical rheumatology: the arthritis research campaign's clinical trials collaboration in association with the MRC clinical trials unit, BSR and BOA,” Rheumatology, vol. 42, no. 6, pp. 713–715, 2003. View at Publisher · View at Google Scholar · View at Scopus
  16. D. Erkan, Y. Yazici, R. Sobel, and M. D. Lockshin, “Primary antiphospholipid syndrome: functional outcome after 10 years,” Journal of Rheumatology, vol. 27, no. 12, pp. 2817–2821, 2000. View at Scopus
  17. R. H. Derksen and P. G. de Groot, “Towards evidence-based treatment of thrombotic antiphospholipid syndrome,” Lupus, vol. 19, no. 4, pp. 470–474, 2010. View at Publisher · View at Google Scholar · View at Scopus
  18. M. A. Khamashta, M. J. Cuadrado, F. Mujic, N. A. Taub, B. J. Hunt, and G. R. V. Hughes, “The management of thrombosis in the antiphospholipid-antibody syndrome,” The New England Journal of Medicine, vol. 332, no. 15, pp. 993–997, 1995. View at Publisher · View at Google Scholar · View at Scopus
  19. M. Petri, “Evidence-based management of thrombosis in the antiphospholipid antibody syndrome,” Current Rheumatology Reports, vol. 5, no. 5, pp. 370–373, 2003. View at Scopus
  20. B. Hass, J. Pooley, A. E. Harrington, A. Clemens, and M. Feuring, “Treatment of venous thromboembolism—effects of different therapeutic strategies on bleeding and reoccurrence rates and consideration for future anticoagulant management,” Thrombosis Journal, vol. 10, no. 1, article 24, 2012. View at Publisher · View at Google Scholar
  21. D. Erkan, M. J. Harrison, R. Levy et al., “APLASA study update: primary thrombosis prevention in asymptomatic aPL-positive patients with aspirin,” Thrombosis Research, vol. 114, article 618, 2004.
  22. G. Finazzi, “Primary antithrombotic prevention in carriers of antiphospholipid antibodies without systemic autoimmune disorders,” Lupus, vol. 21, no. 7, pp. 747–750, 2012. View at Publisher · View at Google Scholar
  23. D. Alarcón-Segovia, M. C. Boffa, W. Branch et al., “Prophylaxis of the antiphospholipid syndrome: a consensus report,” Lupus, vol. 12, no. 7, pp. 499–503, 2003. View at Publisher · View at Google Scholar · View at Scopus
  24. M. A. Khamashta, “Primary prevention of thrombosis in subjects with positive antiphospholipid antibodies,” Journal of Autoimmunity, vol. 15, no. 2, pp. 249–253, 2000. View at Publisher · View at Google Scholar · View at Scopus
  25. J. S. Berger, D. L. Brown, and R. C. Becker, “Low-dose aspirin in patients with stable cardiovascular disease: a meta-analysis,” The American Journal of Medicine, vol. 121, no. 1, pp. 43–49, 2008. View at Publisher · View at Google Scholar · View at Scopus
  26. M. H. Edwards, S. Pierangeli, X. Liu, J. H. Barker, G. Anderson, and E. Nigel Harris, “Hydroxychloroquine reverses thrombogenic properties of antiphospholipid antibodies in mice,” Circulation, vol. 96, no. 12, pp. 4380–4384, 1997. View at Scopus
  27. M. Petri, “Hydroxychloroquine use in the Baltimore lupus cohort: effects on lipids, glucose and thrombosis,” Lupus, vol. 5, no. 1, pp. S16–S22, 1996. View at Scopus
  28. D. J. Wallace, M. Linker-Israeli, A. L. Metzger, and V. J. Stecher, “The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE,” Lupus, vol. 2, no. 1, pp. S13–S15, 1993. View at Scopus
  29. D. Erkan, M. J. Harrison, R. Levy et al., “Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: a randomized, double-blind, placebo-controlled trial in asymptomatic antiphospholipid antibody-positive individuals,” Arthritis and Rheumatism, vol. 56, no. 7, pp. 2382–2391, 2007. View at Publisher · View at Google Scholar · View at Scopus
  30. D. G. Wahl, H. Bounameaux, P. de Moerloose, and F. P. Sarasin, “Prophylactic antithrombotic therapy for patients with systemic lupus erythematosus with or without antiphospholipid antibodies: do the benefits outweigh the risks? A decision analysis,” Archives of Internal Medicine, vol. 160, no. 13, pp. 2042–2048, 2000. View at Scopus
  31. G. Finazzi, R. Marchioli, V. Brancaccio et al., “A randomized clinical trial of high-intensity warfarin versus conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS),” Journal of Thrombosis and Haemostasis, vol. 3, no. 5, pp. 848–853, 2005. View at Publisher · View at Google Scholar · View at Scopus
  32. T. Tarr, G. Lakos, H. P. Bhattoa, Y. Shoenfeld, G. Szegedi, and E. Kiss, “Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients,” Lupus, vol. 16, no. 1, pp. 39–45, 2007. View at Publisher · View at Google Scholar · View at Scopus
  33. R. T. Urbanus, B. Siegerink, M. Roest, F. R. Rosendaal, P. G. de Groot, and A. Algra, “Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study,” The Lancet Neurology, vol. 8, no. 11, pp. 998–1005, 2009. View at Publisher · View at Google Scholar · View at Scopus
  34. R. Cervera and CAPS Registry Project Group, “Catastrophic antiphospholipid syndrome (CAPS): update from the CAPS registry,” Lupus, vol. 19, no. 4, pp. 412–418, 2010. View at Publisher · View at Google Scholar · View at Scopus
  35. J. H. Rand, X. X. Wu, A. S. Quinn, and D. J. Taatjes, “Resistance to annexin A5 anticoagulant activity: a thrombogenic mechanism for the antiphospholipid syndrome,” Lupus, vol. 17, no. 10, pp. 922–930, 2008. View at Publisher · View at Google Scholar · View at Scopus
  36. M. G. Tektonidou, K. Laskari, D. B. Panagiotakos, and H. M. Moutsopoulos, “Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies,” Arthritis Care and Research, vol. 61, no. 1, pp. 29–36, 2009. View at Publisher · View at Google Scholar · View at Scopus
  37. C. C. Mok, S. S. K. Tang, C. H. To, and M. Petri, “Incidence and risk factors of thromboembolism in systemic lupus erythematosus: a comparison of three ethnic groups,” Arthritis and Rheumatism, vol. 52, no. 9, pp. 2774–2782, 2005. View at Publisher · View at Google Scholar · View at Scopus
  38. A. Broder and C. Putterman, “Hydroxychloroquine use is associated with lower odds of persistently positive antiphospholipid antibodies and/or lupus anticoagulant in systemic lupus erythematosus,” Journal of Rheumatology, vol. 40, no. 1, pp. 30–33, 2013. View at Publisher · View at Google Scholar
  39. J. A. Girón-González, E. García Del Río, C. Rodríguez, J. Rodríguez-Martorell, and A. Serrano, “Antiphospholipid syndrome and asymptomatic carriers of antiphospholipid antibody: prospective analysis of 404 individuals,” Journal of Rheumatology, vol. 31, no. 8, pp. 1560–1567, 2004. View at Scopus
  40. T. Hereng, M. Lambert, E. Hachulla et al., “Influence of aspirin on the clinical outcomes of 103 anti-phospholipid antibodies-positive patients,” Lupus, vol. 17, no. 1, pp. 11–15, 2008. View at Publisher · View at Google Scholar · View at Scopus
  41. R. Kaiser, C. M. Cleveland, and L. A. Criswell, “Risk and protective factors for thrombosis in systemic lupus erythematosus: results from a large, multi-ethnic cohort,” Annals of the Rheumatic Diseases, vol. 68, no. 2, pp. 238–241, 2009. View at Publisher · View at Google Scholar · View at Scopus
  42. E. Rubenstein, D. G. Arkfeld, S. Metyas, S. Shinada, S. Ehresmann, and H. A. Liebman, “Rituximab treatment for resistant antiphospholipid syndrome,” Journal of Rheumatology, vol. 33, no. 2, pp. 355–357, 2006. View at Scopus
  43. J. H. Rand, X. X. Wu, A. S. Quinn et al., “Hydroxychloroquine protects the annexinA5 anticoagulant shield from disruption by antiphospholipid antibodies: evidence for a novel effect for an old antimalarial drug,” Blood, vol. 115, no. 11, pp. 2292–2299, 2010. View at Publisher · View at Google Scholar · View at Scopus
  44. G. Ruiz-Irastorza, M. Egurbide, J. Pijoan et al., “Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus,” Lupus, vol. 15, no. 9, pp. 577–583, 2006. View at Publisher · View at Google Scholar · View at Scopus
  45. K. S. Ginsburg, M. H. Liang, L. Newcomer et al., “Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis,” Annals of Internal Medicine, vol. 117, no. 12, pp. 997–1002, 1992. View at Scopus
  46. D. G. Wahl, F. Guillemin, E. de Maistre, C. Perret, T. Lecompte, and G. Thibaut, “Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus. A meta-analysis,” Lupus, vol. 6, no. 5, pp. 467–473, 1997. View at Scopus
  47. D. Alarcon-Segovia, M. E. Perez-Vazquez, A. R. Villa, C. Drenkard, and J. Cabiedes, “Preliminary classification criteria for the antiphospholipid syndrome within systemic lupus erythematosus,” Seminars in Arthritis and Rheumatism, vol. 21, no. 5, pp. 275–286, 1992. View at Publisher · View at Google Scholar · View at Scopus
  48. M. E. Perez-Vazquez, A. R. Villa, C. Drenkard, J. Cabiedes, and D. Alarcon-Segovia, “Influence of disease duration, continued followup and further antiphospholipid testing on the frequency and classification category of antiphospholipid syndrome in a cohort of patients with systemic lupus erythematosus,” Journal of Rheumatology, vol. 20, no. 3, pp. 437–442, 1993. View at Scopus
  49. N. M. Shah, M. A. Khamashta, T. Atsumi, and G. R. V. Hughes, “Outcome of patients with anticardiolipin antibodies: a 10 year follow-up of 52 patients,” Lupus, vol. 7, no. 1, pp. 3–6, 1998. View at Publisher · View at Google Scholar · View at Scopus
  50. V. Pengo, A. Ruffatti, C. Legnani et al., “Incidence of a first thromboembolic event in asymptomatic carriers of high-risk antiphospholipid antibody profile: a multicenter prospective study,” Blood, vol. 118, no. 17, pp. 4714–4718, 2011. View at Publisher · View at Google Scholar · View at Scopus
  51. G. Guyatt, D. Gutterman, M. H. Baumann et al., “Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physicians task force,” Chest, vol. 129, no. 1, pp. 174–181, 2006. View at Publisher · View at Google Scholar · View at Scopus
  52. G. Bertsias, J. P. Ioannidis, J. Boletis et al., “EULAR recommendations for the management of systemic lupus erythematosus. Report of a task force of the EULAR standing committee for international clinical studies including therapeutics,” Annals of the Rheumatic Diseases, vol. 67, no. 2, pp. 195–205, 2008. View at Publisher · View at Google Scholar · View at Scopus
  53. H. N. Hodis, F. P. Quismorio Jr., E. Wickham, and D. H. Blankenhorn, “The lipid, lipoprotein, and apolipoprotein effects of hydroxychloroquine in patients with systemic lupus erythematosus,” Journal of Rheumatology, vol. 20, no. 4, pp. 661–665, 1993. View at Scopus
  54. B. J. Fessler, G. S. Alarcón, G. McGwin et al., “Systemic lupus erythematosus in three ethnic groups: XVI. Association of hydroxychloroquine use with reduced risk of damage accrual,” Arthritis and Rheumatism, vol. 52, no. 5, pp. 1473–1480, 2005. View at Publisher · View at Google Scholar · View at Scopus
  55. R. Cervera, M. A. Khamashta, J. Font et al., “Morbidity and mortality in systemic lupus erythematosus during a 5-year period. A multicenter prospective study of 1,000 patients,” Annals of the Rheumatic Diseases, vol. 68, no. 3, pp. 1428–1432, 2009.
  56. A. Martinez-Berriotxoa, G. Ruiz-Irastorza, M. V. Egurbide et al., “Transiently positive anticardiolipin antibodies and risk of thrombosis in patients with systemic lupus erythematosus,” Lupus, vol. 16, no. 10, pp. 810–816, 2007. View at Publisher · View at Google Scholar · View at Scopus
  57. D. Erkan, J. T. Merrill, Y. Yazici, L. Sammaritano, J. P. Buyon, and M. D. Lockshin, “High thrombosis rate after fetal loss in antiphospholipid syndrome: effective prophylaxis with aspirin,” Arthritis and Rheumatology, vol. 44, no. 6, pp. 1466–1469, 2001. View at Publisher · View at Google Scholar
  58. G. Finazzi, V. Brancaccio, M. Moia et al., “Natural history and risk factors for thrombosis in 360 patients with antiphospholipid antibodies: a four-year prospective study from the Italian registry,” The American Journal of Medicine, vol. 100, no. 5, pp. 530–536, 1996. View at Publisher · View at Google Scholar · View at Scopus
  59. F. Martínez, M. J. Forner, M. Ruano, N. Abdilla, R. Oltra, and M. J. García-Fuster, “Factors related to the risk of thrombosis in patients with lupus and antiphospholipid antibodies,” Medicina Clinica, vol. 127, no. 11, pp. 405–408, 2006. View at Publisher · View at Google Scholar · View at Scopus
  60. V. Pengo, A. Ruffatti, C. Legnani et al., “Clinical course of high-risk patients diagnosed with antiphospholipid syndrome,” Journal of Thrombosis and Haemostasis, vol. 8, no. 2, pp. 237–242, 2010. View at Publisher · View at Google Scholar · View at Scopus
  61. S. Quenby, R. G. Farquharson, F. Dawood, A. M. Hughes, and J. Topping, “Recurrent miscarriage and long-term thrombosis risk: a case-control study,” Human Reproduction, vol. 20, no. 6, pp. 1729–1732, 2005. View at Publisher · View at Google Scholar · View at Scopus
  62. R. M. Silver, M. L. Draper, J. R. Scott, J. L. Lyon, J. Reading, and D. Ware Branch, “Clinical consequences of antiphospholipid antibodies: an historic cohort study,” Obstetrics and Gynecology, vol. 83, no. 3, pp. 372–377, 1994. View at Scopus
  63. G. Ruiz-Irastorza, M. V. Egurbide, J. Ugalde, and C. Aguirre, “High impact of antiphospholipid syndrome on irreversible organ damage and survival of patients with systemic lupus erythematosus,” Archives of Internal Medicine, vol. 164, no. 1, pp. 77–82, 2004. View at Publisher · View at Google Scholar · View at Scopus
  64. I. N. Bruce, “‘Not only...but also’: factors that contribute to accelerated atherosclerosis and premature coronary heart disease in systemic lupus erythematosus,” Rheumatology, vol. 44, no. 12, pp. 1492–1502, 2005. View at Publisher · View at Google Scholar · View at Scopus
  65. J. Calvo-Alén, S. M. A. Toloza, M. Fernández et al., “Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients,” Arthritis and Rheumatism, vol. 52, no. 7, pp. 2060–2068, 2005. View at Publisher · View at Google Scholar · View at Scopus
  66. P. Rahman, M. B. Urowitz, D. D. Gladman, I. N. Bruce, and J. Genest, “Contribution of traditional risk factors to coronary artery disease in patients with systemic lupus erythematosus,” Journal of Rheumatology, vol. 26, no. 11, pp. 2363–2368, 1999. View at Scopus
  67. G. L. Erre, S. Pardini, R. Faedda, and G. Passiu, “Effect of rituximab on clinical and laboratory features of antiphospholipid syndrome: a case report and a review of literature,” Lupus, vol. 17, no. 1, pp. 50–55, 2008. View at Publisher · View at Google Scholar · View at Scopus
  68. S. Khattri, G. Zandman-Goddard, and E. Peeva, “B-cell directed therapies in antiphospholipid antibody syndrome—new directions based on murine and human data,” Autoimmunity Reviews, vol. 11, no. 10, pp. 717–722, 2012. View at Publisher · View at Google Scholar · View at Scopus
  69. C. López-Pedrera, P. Ruiz-Limón, M.A. Aguirre et al., “Global effects of fluvastatin on the prothrombotic status of patients with antiphospholipid syndrome,” Annals of the Rheumatic Diseases, vol. 70, no. 4, pp. 675–682, 2011. View at Publisher · View at Google Scholar · View at Scopus
  70. V. Murthy, L. Vijaya, D. Erkan, et al., “Effects of Fluvastatin on pro-inflammatory and pro-thrombotic markers in antiphospholipid antibody (APL)-positive patients: preliminary results from an open-label prospective pilot study,” Arthritis and Rheumatism, vol. 63, 2011.
  71. R. Cervera, J. Font, A. Lopez-Soto et al., “Isotype distribution of anticardiolipin antibodies in systemic lupus erythematosus: prospective analysis of a series of 100 patients,” Annals of the Rheumatic Diseases, vol. 49, no. 2, pp. 109–113, 1990. View at Scopus
  72. G. Finazzi, “Aspirin in asymptomatic patients with confirmed positivity of antiphospholipid antibodies? No,” Internal and Emergency Medicine, vol. 3, no. 3, pp. 197–200, 2008. View at Publisher · View at Google Scholar · View at Scopus
  73. M. Gerosa, C. Chighizola, and P. L. Meroni, “Aspirin in asymptomatic patients with confirmed positivity of antiphospholipid antibodies? Yes (in some cases),” Internal and emergency medicine, vol. 3, no. 3, pp. 201–203, 2008. View at Publisher · View at Google Scholar · View at Scopus
  74. R. Willis, A. M. Seif, G. McGwin Jr. et al., “Effect of hydroxychloroquine treatment on pro-inflammatory cytokines and disease activity in SLE patients: data from LUMINA (LXXV), a multiethnic US cohort,” Lupus, vol. 21, no. 8, pp. 830–835, 2012. View at Publisher · View at Google Scholar