Antiphospholipid Syndrome: Management & Future Directions

The Next Decade
Jason S. Knight, MD, PhD, the Marvin and Betty Danto Research Professor of Connective Tissue Research and associate professor of internal medicine at the University of Michigan, Ann Arbor, concluded the session with an overview of what to expect in the new decade for APS. He foresees the field becoming more personalized with rheumatologists treating APS proactively rather than reactively. Advances in immunomodulation should also make it possible to treat APS at its source. Finally, he called for more investigators to become interested in APS to generate a better understanding of B cell repertoire, metabolomics, epigenetics and the influence of the microbiome.

Lara C. Pullen, PhD, is a medical writer based in the Chicago area.

References

1. De Laat B, Derkson RHWM, van Lummel M, et al. Pathogenic anti-β₂-glycoprotein I antibodies recognize domain I of β₂-glycoprotein I only after a conformational change. Blood. 2006 Mar 1;107(5):1916–1924.
2. Tektonidou MG, Andreoli L, Limper M, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis. 2019 Oct;78(10):1296–1304.
3. Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018 Sep 27;132(13):1365–1371.
4. Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, et al. Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome: A randomized noninferiority trial. Ann Intern Med. 2019 Nov 19;171(10):685–694.
5. Bala MM, Celinska-Lowenhoff M, Szot W, et al. Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome (Review). Cochrane Database Syst Rev. 2020 Oct 12;10:CD012169.