Retirada de la anticoagulación en el síndrome antifosfolípido primario cuando se negativizan los anticuerpos anticardiolipina

Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion?

“…Out of 1006 screened studies, a total of four [3][4][5][6] met the inclusion criteria, including 47 thrombotic APS patients with persistently aPL seroconversion. Three out of four studies, including 23 thrombotic APS patients, described discontinuation of anticoagulation therapy after aPL seroconversion.…”

“…Two studies [4,5] included patients with 2 consecutive aPL seroconversion, however one of those studies [5] retested patients to confirm aPL disappearance after five years. Two studies [6,7] did not define the aPL negativization, however one study [7], reported patients with at least nine negative determinations of…”

“…Of note, one study reported patients positive for aCL IgG at low titer in most cases and one patients positive for LA only but with negative results in a second determination [4]. Another study included mainly patients positive for LA only [5]; only one study [6] tested their cohort of patients for noncriteria aPL (anti-annexin A5 antibodies).…”

“…After a median duration of follow-up of 19 months (4-66.75) since the cessation of oral anticoagulantion, one out of 10 patients relapsed developing pulmonary embolism. The remaining two studies [4,7], included 6 primary APS and 7 primary APS patients, respectively. Anticoagulation therapy was discontinued in both studies and after a follow-up of 21 ± 12 months and 18 months, respectively, no recurrences were found.…”

Intensity and Duration of Anticoagulation Therapy in Antiphospholipid Syndrome

“…On the other hand, a recent study analyzed the outcome of a series of 10 cases with definite APS (defined by venous thrombosis and aCL positivity on at least two occasions), who had been treated with warfarin for a minimum of 12 months and who eventually became aPL negative. 51 An interesting finding was the absence of recurrent thrombosis after anticoagulation withdrawal during the 21 months of follow-up.…”