Abstract
Optimal management of patients with the antiphospholipid syndrome (APS) remains a problem. There is now good evidence that those with thrombosis will be subject to recurrences and require long-term, possibly lifelong, oral anticoagulation. Steroids and immunosuppressive drugs aiming at a reduction of the antibody levels have not provided long-term benefit. Only prospective and controlled clinical trials can give a definitive answer to the optimal thrombotic prophylaxis in patients with the APS.