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Treatment of Antiphospholipid Antibody Syndrome
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To the Editor: In their Clinical Review of antiphospholipid antibody syndrome (APS) management, Dr Lim and colleagues1 examine evidence for treatment of 2 distinct groups of patients: those with antiphospholipid antibodies and those with definite APS. Classification criteria for definite APS, including laboratory criteria, have been recently updated.2 The new criteria reinforce the importance of persistent positivity and require positive laboratory test results at least 12 weeks apart. Data from the literature derived from patients with a single positive antiphospholipid antibody test do not apply to patients with definite APS.
Although it has been demonstrated that high-intensity warfarin is not more effective than moderate-intensity warfarin for venous thromboembolism in patients with APS,3-4 it has not been demonstrated that aspirin is equivalent to warfarin adjusted to a target international normalized ratio (INR) of 2.0 to 3.0 in patients with definite APS and prior stroke. Thus, the fact that aspirin and moderate-intensity . . . [Full Text of this Article]
Denis Wahl, MD, PhD
d.wahl@chu-nancy.fr
Internal and Vascular Medicine Unit
Nancy University Hospital
Veronique Regnault, PhD
INSERM U 734
Nancy, France
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