What is the prognosis of antiphospholipid syndrome (APS)?

Updated: Nov 24, 2020
  • Author: Suneel Movva, MD; Chief Editor: Herbert S Diamond, MD  more...
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With appropriate medication and lifestyle modifications, most individuals with primary antiphospholipid syndrome (APS) lead normal healthy lives. However, subsets of patients continue to have thrombotic events despite aggressive therapies. In these patients and in patients with catastrophic APS, the disease course can be devastating, often leading to significant morbidity or early death.

In large European cohort studies, 10-year survival is approximately 90-94%. [35]

A retrospective study suggested that hypertension or medium-to-high titers of IgG anticardiolipin antibody are risk factors for a first thrombotic event in asymptomatic patients with antiphospholipid (aPL) antibodies. [36] Primary prophylaxis against thrombosis appears to offer significant protection in such cases. Annual incidence of first thrombosis is approximately 0-5% in patients with a positive aPL test without previous thrombosis. [9]

Patients with secondary APS carry a prognosis similar to that of patients with primary APS; in the former, however, morbidity and mortality may also be influenced by these patients' underlying autoimmune or rheumatic condition. In patients with SLE and APS, aPL antibodies have been associated with neuropsychiatric disease and have been recognized as a major predictor of irreversible organ damage.

Women with aPL antibodies who experience recurrent miscarriages may have favorable prognoses in subsequent pregnancies if treated with aspirin and heparin.

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