Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis
and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The
development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in
APS patients. However, although APS has been reported for more than 30 years, there has been no optimal
regimen for its prevention or for the management of thrombosis, mainly because the mainstay
treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology.
Instead, the treatments commonly used are aimed at general thrombotic disorders. Warfarin is the
most commonly used vitamin K antagonist (VKA), in addition to anti-platelet medications, such as aspirin
and clopidogrel. Over the last decade, novel non-VKA oral anticoagulants, including rivaroxaban,
apixaban and dabigatran, as well as immunomodulatory agents, such as rituximab, eculizumab, hydroxychloroquine,
statins and sirolimus, have also been used. In this review, we discuss the current
treatment strategies and future treatment outlook for thrombotic APS.