Therapeutic strategies in antiphospholipid syndrome
Estrategias terapéuticas en el síndrome antifosfolipídico
Ricard Cervera
Servicio de Enfermedades Autoinmunes, Hospital Clínic, Barcelona, Spain
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array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jesús Tornero Molina, Raimon Sanmartí Sala, Vicente Rodríguez Valverde, Emilio Martín Mola, José Luis Marenco de la Fuente, Isidoro González Álvaro, Santiago Muñoz Fernández, Juan Gómez-Reino Carnota, Luis Carreño Pérez, Enrique Batlle Gualda, Alejandro Balsa Criado, José Luis Andreu, José María Álvaro-Gracia, Juan Antonio Martínez López, Estíbaliz Loza Santamaría" "autores" => array:15 [ 0 => array:2 [ "nombre" => "Jesús" "apellidos" => "Tornero Molina" ] 1 => array:2 [ "nombre" => "Raimon" "apellidos" => "Sanmartí Sala" ] 2 => array:2 [ "nombre" => "Vicente" "apellidos" => "Rodríguez Valverde" ] 3 => array:2 [ "nombre" => "Emilio" "apellidos" => "Martín Mola" ] 4 => array:2 [ "nombre" => "José Luis" "apellidos" => "Marenco de la Fuente" ] 5 => array:2 [ "nombre" => "Isidoro" "apellidos" => "González Álvaro" ] 6 => array:2 [ "nombre" => "Santiago" "apellidos" => "Muñoz Fernández" ] 7 => array:2 [ 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=> "37" "paginaFinal" => "42" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Ricard Cervera" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Ricard" "apellidos" => "Cervera" "email" => array:1 [ 0 => "rcervera@clinic.ub.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Enfermedades Autoinmunes, Hospital Clínic, Barcelona, Spain" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estrategias terapéuticas en el síndrome antifosfolipídico" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-11-19" "fechaAceptado" => "2008-11-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112320" "palabras" => array:4 [ 0 => "Antiphospholipid syndrome" 1 => "Antiphospholipid antibodies" 2 => "Anticardiolipin antibodies" 3 => "Lupus anticoagulant" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112319" "palabras" => array:4 [ 0 => "Síndrome antifosfolipídico" 1 => "Anticuerpos antifosfolipídicos" 2 => "Anticuerpos anticardiolipina" 3 => "Anticoagulante lúpico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The classical clinical picture of the antiphospholipid syndrome (APS) is characterized by venous or arterial thromboses, fetal losses and thrombocytopenia, in the presence of antiphospholipid antibodies (aPL), namely lupus anticoagulant, anticardiolipin antibodies or antibodies directed to various proteins, mainly β2 glycoprotein I, or all three. Apart from being “primary” (without any discernable underlying systemic autoimmune disease), or associated to another disease (usually to systemic lupus erythematosus), it may also occur rapidly over days or weeks when it has been termed “catastrophic” APS. Therapy should not primarily be directed at effectively reducing the aPL levels and the use of immunotherapy (including high dose steroid administration, immunosuppression or plasma exchange) is generally not indicated, unless in the catastrophic APS. Treatment of APS patients should be based on the use of antiaggregant and anticoagulant therapy.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El síndrome antifosfolipídico (SAF) se caracteriza por la asociación de los anticuerpos antifosfolipídicos (AAF) con trombosis de repetición, abortos o pérdidas fetales recurrentes y trombocitopenia. Los AAF más estudiados son los anticuerpos anticardiolipina, el anticoagulante lúpico y los anticuerpos anti-β2-glucoproteína I. El SAF puede presentarse de forma aislada, denominándose SAF primario, o bien asociado a otras enfermedades autoinmunes sistémicas, fundamentalmente a lupus eritematoso sistémico. Más recientemente, se ha descrito un subgrupo de SAF en el que los pacientes desarrollan múltiples trombosis durante un corto espacio de tiempo, que se ha denominado SAF catastrófico. Aunque parece clara la asociación entre la presencia de AAF y trombosis, la actitud terapéutica no debe ir dirigida primariamente a la eliminación o a la reducción de los niveles de estos anticuerpos mediante recambios plasmáticos, gammaglobulinas intravenosas o inmunodepresores (excepto en el SAF catastrófico), y a que no existe una clara correlación entre los niveles de los AAF y los episodios trombóticos. El tratamiento de estos pacientes debe basarse en el uso de antiagregantes plaquetarios o anticoagulantes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:49 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "The antiphospholipid syndrome IIautoimmune thrombosis" "serieFecha" => "2002" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality in the catastrophic antiphospholipid syndrome. Causes of death and prognostic factors in a series of 250 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Bucciarelli" 1 => "G. Espinosa" 2 => "R. Cervera" 3 => "D. Erkan" 4 => "J.A. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 10 | 14 |
| 2024 October | 39 | 28 | 67 |
| 2024 September | 21 | 17 | 38 |
| 2024 August | 47 | 39 | 86 |
| 2024 July | 29 | 28 | 57 |
| 2024 June | 43 | 35 | 78 |
| 2024 May | 62 | 41 | 103 |
| 2024 April | 41 | 27 | 68 |
| 2024 March | 41 | 42 | 83 |
| 2024 February | 41 | 27 | 68 |
| 2024 January | 30 | 24 | 54 |
| 2023 December | 30 | 22 | 52 |
| 2023 November | 29 | 25 | 54 |
| 2023 October | 28 | 33 | 61 |
| 2023 September | 35 | 37 | 72 |
| 2023 August | 22 | 15 | 37 |
| 2023 July | 25 | 22 | 47 |
| 2023 June | 24 | 14 | 38 |
| 2023 May | 16 | 7 | 23 |
| 2023 April | 22 | 13 | 35 |
| 2023 March | 57 | 30 | 87 |
| 2023 February | 37 | 25 | 62 |
| 2023 January | 30 | 38 | 68 |
| 2022 December | 30 | 45 | 75 |
| 2022 November | 32 | 34 | 66 |
| 2022 October | 37 | 40 | 77 |
| 2022 September | 33 | 37 | 70 |
| 2022 August | 32 | 53 | 85 |
| 2022 July | 32 | 51 | 83 |
| 2022 June | 30 | 34 | 64 |
| 2022 May | 33 | 54 | 87 |
| 2022 April | 31 | 51 | 82 |
| 2022 March | 60 | 59 | 119 |
| 2022 February | 45 | 40 | 85 |
| 2022 January | 29 | 29 | 58 |
| 2021 December | 30 | 43 | 73 |
| 2021 November | 33 | 47 | 80 |
| 2021 October | 29 | 54 | 83 |
| 2021 September | 36 | 51 | 87 |
| 2021 August | 23 | 51 | 74 |
| 2021 July | 27 | 40 | 67 |
| 2021 June | 24 | 46 | 70 |
| 2021 May | 33 | 38 | 71 |
| 2021 April | 75 | 74 | 149 |
| 2021 March | 57 | 30 | 87 |
| 2021 February | 50 | 25 | 75 |
| 2021 January | 47 | 14 | 61 |
| 2020 December | 30 | 20 | 50 |
| 2020 November | 33 | 22 | 55 |
| 2020 October | 21 | 20 | 41 |
| 2020 September | 34 | 22 | 56 |
| 2020 August | 26 | 17 | 43 |
| 2020 July | 20 | 8 | 28 |
| 2020 June | 37 | 17 | 54 |
| 2020 May | 39 | 18 | 57 |
| 2020 April | 36 | 21 | 57 |
| 2020 March | 19 | 19 | 38 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 4 | 0 | 4 |
| 2019 September | 4 | 0 | 4 |
| 2019 June | 2 | 0 | 2 |
| 2019 March | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 3 | 1 | 4 |
| 2018 April | 24 | 14 | 38 |
| 2018 March | 23 | 23 | 46 |
| 2018 February | 19 | 18 | 37 |
| 2018 January | 13 | 10 | 23 |
| 2017 December | 16 | 15 | 31 |
| 2017 November | 20 | 22 | 42 |
| 2017 October | 19 | 12 | 31 |
| 2017 September | 14 | 13 | 27 |
| 2017 August | 14 | 19 | 33 |
| 2017 July | 18 | 23 | 41 |
| 2017 June | 45 | 23 | 68 |
| 2017 May | 38 | 23 | 61 |
| 2017 April | 22 | 16 | 38 |
| 2017 March | 24 | 27 | 51 |
| 2017 February | 16 | 12 | 28 |
| 2017 January | 25 | 10 | 35 |
| 2016 December | 72 | 25 | 97 |
| 2016 November | 56 | 11 | 67 |
| 2016 October | 74 | 12 | 86 |
| 2016 September | 59 | 15 | 74 |
| 2016 August | 41 | 8 | 49 |
| 2016 July | 23 | 9 | 32 |
| 2016 February | 0 | 6 | 6 |
| 2016 January | 4 | 0 | 4 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 3 | 0 | 3 |
| 2015 July | 16 | 7 | 23 |
| 2015 June | 27 | 69 | 96 |
| 2015 May | 36 | 45 | 81 |
| 2015 April | 20 | 57 | 77 |
| 2015 March | 22 | 36 | 58 |
| 2015 February | 38 | 23 | 61 |
| 2015 January | 41 | 32 | 73 |
| 2014 December | 37 | 32 | 69 |
| 2014 November | 12 | 34 | 46 |
| 2014 October | 39 | 24 | 63 |
| 2014 September | 21 | 16 | 37 |
| 2014 August | 24 | 22 | 46 |
| 2014 July | 32 | 31 | 63 |
| 2014 June | 40 | 17 | 57 |
| 2014 May | 36 | 28 | 64 |
| 2014 April | 36 | 15 | 51 |
| 2014 March | 37 | 22 | 59 |
| 2014 February | 23 | 13 | 36 |
| 2014 January | 26 | 22 | 48 |
| 2013 December | 34 | 16 | 50 |
| 2013 November | 20 | 20 | 40 |
| 2013 October | 33 | 26 | 59 |
| 2013 September | 52 | 27 | 79 |
| 2013 August | 30 | 16 | 46 |
| 2013 July | 32 | 15 | 47 |
| 2013 June | 34 | 16 | 50 |
| 2013 May | 26 | 19 | 45 |
| 2013 April | 30 | 18 | 48 |
| 2013 March | 28 | 25 | 53 |
| 2013 February | 32 | 11 | 43 |
| 2013 January | 22 | 9 | 31 |
| 2012 December | 25 | 11 | 36 |
| 2012 November | 15 | 13 | 28 |
| 2012 October | 5 | 8 | 13 |
| 2012 September | 9 | 4 | 13 |
| 2012 June | 4 | 0 | 4 |
| 2012 May | 1 | 0 | 1 |
| 2012 April | 4 | 0 | 4 |
| 2012 March | 5 | 0 | 5 |
| 2012 February | 2 | 0 | 2 |
| 2012 January | 1 | 0 | 1 |
| 2011 December | 8 | 0 | 8 |
| 2011 November | 2 | 0 | 2 |
| 2011 October | 3 | 0 | 3 |
| 2011 August | 1 | 0 | 1 |
| 2011 June | 4 | 0 | 4 |
| 2011 April | 1 | 0 | 1 |
| 2011 March | 3 | 0 | 3 |
| 2011 February | 6 | 0 | 6 |
| 2011 January | 5 | 0 | 5 |
| 2010 December | 20 | 0 | 20 |
| 2010 November | 4 | 0 | 4 |
| 2010 October | 9 | 0 | 9 |
| 2010 September | 3 | 0 | 3 |
| 2010 August | 12 | 0 | 12 |
| 2010 July | 13 | 0 | 13 |
| 2010 June | 10 | 0 | 10 |
Show all
