Treatment of Antiphospholipid syndrome

• UFH/LMWH → warfarin (lifelong for most Pts)

• Rivaroxaban inferior to warfarin in triple positive (⊕ ACL, LA, & β2-GP) (Blood 2018;132:1365)

• Initial venous thrombosis: INR 2–3 (NEJM 2003;349:1133; J Thromb Haemost 2005;3:848)

• Initial arterial thrombosis: typically INR 2–3 + ASA 81 mg/d

• Recurrent thrombosis on warfarin: consider INR 3–4 vs. LMWH or fondaparinux