How Is Antiphospholipid Antibody Syndrome Treated?

Antiphospholipid antibody syndrome (APS) has no cure, but some medicines can help prevent complications. The goals of treatment are to prevent blood clots from forming and keep existing clots from getting larger.

If you have APS and another autoimmune disorder, such as lupus, it’s important to control that condition as well. When the other condition is controlled, APS may cause fewer problems.

Research is ongoing for new ways to treat APS.

Medicines

Anticoagulants, or "blood thinners," are used to stop blood clots from forming. They also keep existing blood clots from getting larger. These medicines are taken as either a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).

Warfarin and heparin are two blood thinners used to treat people who have APS. Warfarin is given in pill form. (Coumadin^® is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.

Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.

Sometimes aspirin is used with warfarin. In other cases, aspirin may be used alone. Aspirin also thins the blood and helps prevent blood clots.

Blood thinners don’t prevent or treat APS. They simply reduce the risk of further blood clotting. Treatment with these medicines is long term. Discuss all treatment options with your doctor.

Side Effects

The most common side effect of blood thinners is bleeding. This happens if the medicine thins your blood too much. This side effect can be life threatening.

Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually need regular blood tests, called PT and PTT tests, to check how well their blood is clotting.

These tests also show whether you're taking the right amount of medicine. Your doctor will check to make sure that you’re taking enough medicine to prevent clots, but not so much that it causes bleeding.

Talk to your doctor about the warning signs of internal bleeding and when to seek emergency care. (For more information, see "Living With Antiphospholipid Antibody Syndrome.")

Treatment During Pregnancy

Pregnant women who have APS can have successful pregnancies. With proper treatment, women who have APS are more likely to carry their babies to term.

Pregnant women who have APS usually are treated with heparin or heparin and low-dose aspirin.

Babies whose mothers have APS are at higher risk for slowed growth while in the womb. If you’re pregnant and have APS, you may need to have extra ultrasound tests (sonograms) to check the fetus’ growth. This test uses sound waves to look at organs and structures inside your body.

Treatment for Other Medical Conditions

People who have APS are at increased risk for thrombocytopenia. This is a condition in which your blood has a low number of blood cells called platelets. Platelets help the blood clot. If you have APS, you will need regular complete blood counts (a type of blood test) to count the number of platelets in your blood.

Thrombocytopenia is treated with medicines and medical procedures. For more information, see "How Is Thrombocytopenia Treated?"

If you have other health problems, such as heart disease or diabetes, work with your doctor to manage them.