Treatments for antiphospholipid antibodies

Lupus Foundation of America

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If a person has lupus anticoagulant, anticardiolipin antibody, or anti-β2 glycoprotein I, but has never had a complication from thrombosis (a blood clot), some doctors will prescribe a daily baby (81 mg) aspirin tablet. However, it is always a good idea to reduce other risk factors for clotting, such as being overweight or smoking. Oral contraceptives and hormone replacement therapy should be avoided. Also, research studies suggest that the antimalarial drug hydroxychloroquine (Plaquenil) may play a protective role against thrombosis.

If a person has had a thrombotic complication and has these antibodies, treatment may depend on where the clot occurred. In general, after a blood clot has occurred, treatment consists of “thinning” the blood to prevent future clots. This is usually done using warfarin (Coumadin), with aspirin sometimes added.

Some individuals who had initially been treated with aspirin have had a second episode of thrombosis and have then been treated with warfarin. A few have had a second episode of thrombosis even while on warfarin; however, treatment with warfarin appears to be successful overall. The length of time that this treatment is necessary is unclear. Many physicians recommend long-term or even lifelong treatment to prevent future episodes of thrombosis.

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