Monitoring of anticoagulation in thrombotic antiphospholipid syndrome

Anticoagulation is central to the management of thrombotic antiphospholipid syndrome (APS). The standard anticoagulant treatment for APS life-long warfarin or an alternative vitamin K antagonist. role direct oral anticoagulants not established due lack definitive evidence and has recently been addressed in international guidance. Other options include low molecular weight heparin, unfractionated fondaparinux. In patients, lupus can affect phospholipid-dependent coagulation monitoring tests, so that they may reflect true anticoagulation intensity. Accurate assessment intensity essential, optimize dosing facilitate thrombus resolution; minimize risk recurrent thrombosis bleeding; inform whether related breakthrough while on therapeutic anticoagulation, subtherapeutic non-adherence, spurious results; guide bleeding. Knowledge also informs comparison regimens clinical studies. Considerations regarding and/or patients underpin appropriate special situations, notably APS-related severe renal impairment, which occur APS/systemic erythematosus-related nephropathy catastrophic APS; thrombocytopenia. Anticoagulant require consideration anticoagulant-refractory during pregnancy. this review, we summarize tests generally used therapy, use main considered APS, effects strategies APS.