Haemostasis Research Unit, Department of Haematology, University College London, London, UK.
University College London Hospitals NHS Foundation Trust, London, UK.
Lupus. 2020 Oct;29(12):1571-1593. doi: 10.1177/0961203320950461.
Antiphospholipid syndrome (APS), an acquired autoimmune thrombophilia, is characterised by thrombosis and/or pregnancy morbidity in association with persistent antiphospholipid antibodies. The 16th International Congress on Antiphospholipid Antibodies Task Force on APS Treatment Trends reviewed the current status with regard to existing and novel treatment trends for APS, which is the focus of this Task Force report. The report addresses current treatments and developments since the last report, on the use of direct oral anticoagulants in patients with APS, antiplatelet agents, adjunctive therapies (hydroxychloroquine, statins and vitamin D), targeted treatment including rituximab, belimumab, and anti-TNF agents, complement inhibition and drugs based on peptides of beta-2-glycoprotein I. In addition, the report summarises potential new players, including coenzyme Q10, adenosine receptor agonists and adenosine potentiation. In each case, the report provides recommendations for clinicians, based on the current state of the art, and suggests a clinical research agenda. The initiation and development of appropriate clinical studies requires a focus on devising suitable outcome measures, including a disease activity index, an optimal damage index, and a specific quality of life index.
抗磷脂综合征（APS）是一种获得性自身免疫性血栓形成倾向，其特征是存在持续的抗磷脂抗体，并与血栓形成和/或妊娠并发症相关。第 16 届国际抗磷脂抗体大会 APS 治疗趋势工作组回顾了 APS 现有和新型治疗趋势的现状，这是本工作组报告的重点。该报告针对自上次报告以来（关于在 APS 患者中使用直接口服抗凝剂、抗血小板药物、辅助治疗（羟氯喹、他汀类药物和维生素 D）、包括利妥昔单抗、贝利木单抗和抗 TNF 药物在内的靶向治疗、补体抑制以及基于β-2-糖蛋白 I 肽的药物）的现有治疗方法和进展情况进行了阐述。此外，该报告还总结了潜在的新药物，包括辅酶 Q10、腺苷受体激动剂和腺苷增强剂。在每种情况下，该报告都根据当前的最新技术为临床医生提供了建议，并提出了临床研究议程。启动和开展适当的临床研究需要关注设计合适的疗效指标，包括疾病活动指数、最佳损伤指数和特定的生活质量指数。
