The APSANTICO-registry - Evaluation of the Efficacy and Safety of Different Anticoagulants in Patients With Thromboembolic Antiphospholipid Syndrome (APS)

Antiphospholipid syndrome is a thrombophilic diathesis characterised by the occurrence of recurrent, unprovoked thromboembolic events (arterial, venous, microvascular) in combination with the presence of specific APS antibodies.

A distinction is made between different subtypes of APS. One is the thrombotic antiphospholipid syndrome (APS), which is the focus of the registry, and the other is obstetric APS, which is characterised by obstetric complications.

The particular challenge in dealing with APS patients is to establish an adequate therapy regime, as some patients suffer from an increased risk of recurrent thrombosis despite anticoagulation and/or aggregation inhibition.

The standard medication for antiphospholipid syndrome is based on the use of vitamin K antagonists (VKA). This regimen is essential to follow, especially in high-risk patients with positive lupus anticoagulants and/or triple positive antiphospholipid antibodies.

In 2019, a 'Red Hand Letter' was issued advising against treating APS patients with direct oral anticoagulants (DOACs) but so far some studies suggest that alternative anticoagulation with DOACs may be beneficial in a selected patient population with a single- or double-positive antiphospholipid antibody profile.