Antiphospholipid syndrome
ICD-10 D68.6 · ICD-11 4A45

Treatment of Antiphospholipid Syndrome After a First Unprovoked Venous Thrombosis

Clinical Scenario

This protocol applies to patients with definite antiphospholipid syndrome (APS) who have had a first unprovoked venous thrombosis. In this setting, vitamin K antagonist therapy is recommended, and long-term anticoagulation is indicated.

Management Approach

Once the initial anticoagulation target has been achieved, adjustments to the anticoagulant regimen — involving the addition of another agent or a change in therapy type — may be considered. The complete decision pathway is in the full protocol.

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References

DOI: 10.1136/annrheumdis-2019-215213

In patients with definite APS and first venous thrombosis: A. Treatment with VKA with a target INR 2–3 is recommended.

In patients with unprovoked first venous thrombosis, anticoagulation should be continued long term.

If the target INR of 2–3 had been achieved, addition of LDA, increase of INR target to 3–4 or change to LMWH may be considered.

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