What are the treatment options for catastrophic antiphospholipid syndrome (APS)?

Updated: Sep 30, 2018
  • Author: Suneel Movva, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Patients with catastrophic APS (CAPS) are generally very ill, often with active SLE. Treatment (which is not based on controlled trials) consists of attention to associated disorders (eg, infection, SLE) and intensive anticoagulation, with consideration of the following [25] :

  • Plasma exchange
  • Cyclophosphamide, in patients with SLE; note that use in first-trimester pregnancy increases risk of fetal loss [22]
  • In refractory or relapsing cases, new therapies, such as rituximab and possibly eculizumab

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