|
|
Blood, Vol. 114, Issue 10, 2020-2030, September 3, 2009
How I treat the antiphospholipid syndrome
Blood Giannakopoulos and Krilis
114: 2020
Supplemental materials for: Giannakopoulos and Krilis
Search strategy The Medline data base was used. The relevant evidence based publications were obtained by entering the following terms into the search engine: “antiphospholipid antibodies,” “antiphospholipid syndrome,” “anticardiolipin antibodies,” “lupus anticoagulant,” “pulmonary embolus,” “thrombosis” included the subheading-“carotid artery,” “cavernous sinus,” “coronary,” intracranial embolism,” “lateral sinus,” “sagital sinus,” “intracranial sinus,” and “venous,” “miscarriages,” “spontaneous abortion,” “human” and “randomized controlled trial” and “meta-analysis.” We also searched the Cochrane data base. The period for examination was from 1980 to April 2009. The articles were studied, then depending on the specific issues which were being addressed, divided according to the subtitles in the review. The topic of venous thrombosis was subdivided into two main areas, the intensity of anticoagulation, the duration of anticoagulation. On the topic of duration of anticoagulation in the context of venous thromboembolism we have also examined the evidence base from the general literature. The term “general” is used herein to denote that in the group of patients studied an attempt was not made to assess whether the patients were positive for antiphospholipid antibodies. We have used the search terms “venous thromboembolism,” “anticoagulation,” “vitamin K antagonist,” “warfarin,” “coumarins,” “duration,” “randomized controlled trials” and “meta-analyses.” We also examined recent review articles on this topic and the references contained therein. Another search strategy involved the words; “hemorrhage,” “bleeding,” “warfarin,” “coumarin,” “vitamin K antagonist” and “reviews.” The topic of arterial thrombosis mainly focuses on non-cardioembolic stroke as this is what the current evidence base is strongest on. The literature derived from the general population on secondary prophylaxis for non-cardioembolic stroke or transient ischemia was also examined. The search terms used were “stroke,” “TIA,” “noncardioembolic,” “anticoagulant,” “heparin,” “warfarin,” “aspirin,” “clopidogrel and “randomized controlled trial” and “meta-analyses.” The topic of managing venous thrombosis during pregnancy in APS patients was assessed with the following search strategy: “thrombosis,” “antepartum,” “post-partum,” “prophylaxis” and “randomized controlled trial.” Recent evidence based review articles regarding the management of venous thrombosis in pregnancy in the general population were also examined, as were the references contained therein. For topics for which RCT data is not available, such as the management of the catastrophic syndrome and the treatment of thrombotic recurrence despite secondary prophylaxis we have used the data from retrospective studies, plus insights gleaned from our clinical experience.
|
|
