What should I ask my rheumatologist about Antiphospholipid Syndrome (APS)?

From the Guidelines

You should ask your rheumatologist about the following regarding APS syndrome:

Key Questions to Ask

• What are the specific antibodies that I have, such as lupus anticoagulant, anticardiolipin, or anti-beta-2 glycoprotein I, and what do they mean for my treatment and prognosis 1.
• What is the best treatment plan for me, including the type and dose of anticoagulant medication, such as warfarin or aspirin, and how long I will need to take it 1.
• What are the potential risks and benefits of each medication, including the risk of bleeding or clotting 1.
• How often will I need to have my blood tested to monitor my condition and adjust my treatment as needed 1.
• What are the signs and symptoms of a blood clot, and what should I do if I experience any of them 1.
• How will APS syndrome affect my daily life, including my ability to exercise, travel, or become pregnant 1.
• What are the potential complications of APS syndrome, such as recurrent miscarriage, stroke, or heart attack, and how can they be prevented or managed 1.
• What lifestyle changes can I make to help manage my condition, such as maintaining a healthy weight, quitting smoking, or managing stress 1.
• How will my rheumatologist work with other healthcare providers, such as my primary care physician or obstetrician, to coordinate my care 1.

Important Considerations

• The presence of antiphospholipid antibodies (aPL) is a key factor in the diagnosis and management of APS syndrome 1.
• The type and dose of anticoagulant medication will depend on the individual's specific condition and medical history 1.
• Regular blood testing is necessary to monitor the condition and adjust treatment as needed 1.
• Lifestyle changes, such as maintaining a healthy weight and managing stress, can help manage the condition 1.
• Coordination of care with other healthcare providers is essential to ensure comprehensive management of the condition 1.

From the FDA Drug Label

For patients with a first episode of DVT or PE who have documented antiphospholipid antibodies ... treatment for 12 months is recommended and indefinite therapy is suggested

You should ask your rheumatologist about:

• The presence of antiphospholipid antibodies and their implications for your treatment
• The recommended duration of treatment with warfarin
• The target INR range for your specific condition
• The risks and benefits of indefinite anticoagulant treatment 2

From the Research

Questions to Ask Your Rheumatologist About Antiphospholipid Syndrome (APS)

When discussing Antiphospholipid Syndrome (APS) with your rheumatologist, it's essential to be well-informed about the condition, its diagnosis, and management. Here are some key points and questions to consider:

• Diagnosis and Testing:
  • What tests are used to diagnose APS, and what do the results indicate? 3, 4, 5
  • How often should I be tested for antiphospholipid antibodies (aPL), and what are the implications of positive or negative results? 3, 5
• Treatment and Management:
  • What are the treatment options for APS, including anticoagulation therapy and immunosuppression? 3, 4, 6
  • How do direct oral anticoagulants compare to traditional treatments like low-dose aspirin, heparin, and vitamin K antagonists in terms of efficacy and risk? 3
• Risk Factors and Complications:
  • What are the risks associated with APS, including thromboembolic and obstetric complications? 3, 4
  • How does the presence of all three serological criteria (aCL, aB2GP I, and LA) affect my risk profile, and what does "triple positivity" mean for my treatment and management? 3
• Special Considerations:
  • What is seronegative APS (SN-APS), and how is it diagnosed and managed? 7
  • Are there any new or emerging treatments for APS that I should be aware of, including the role of immunosuppression? 6
• Lifestyle and Prevention:
  • Are there any lifestyle changes or preventive measures I can take to reduce my risk of thromboembolic and obstetric complications? 4
  • How can I balance the risks and benefits of different treatment options to optimize my care and quality of life? 3, 4, 6