Nuevas estrategias de tratamiento para el síndrome antifosfolipídico

Antiphospholipid syndrome is a prothrombotic autoimmune disease with thrombotic and obstetric phenotypes. The study therefore aimed to analyse recent evidence on new therapeutic strategies for antiphospholipid syndrome and their efficacy and safety compared with conventional vitamin K antagonist therapy. A PRISMA-guided systematic review was conducted in Medline, Cochrane, Medigraphic, BVS and PubMed, with a sample of 28 studies out of 100 records. Direct oral anticoagulants increased arterial events in high-risk patients; vitamin K antagonists remained the standard; and hydroxychloroquine, rituximab, sirolimus and eculizumab showed benefits in refractory obstetric, non-criteria, vasculopathic and catastrophic manifestations. It was concluded that treatment must be stratified by phenotype and risk.