A Comparison of Two Intensities of Warfarin for the Prevention of Recurrent Thrombosis in Patients with the Antiphospholipid Antibody Syndrome

Warfarin can prevent recurrent thrombosis in patients with the antiphospholipid antibody syndrome, but the intensity of anticoagulation is an unsettled matter. In this randomized trial, patients with the syndrome were assigned to moderate- or high-intensity warfarin. The high-intensity regimen was no more effective than the moderate-intensity regimen. Moderate- versus high-intensity warfarin in the antiphospholipid antibody syndrome. Antiphospholipid antibodies, which include anticardiolipin antibodies and lupus anticoagulant, are associated with both arterial and venous thrombosis. 1 After a first episode of thrombosis, patients with antiphospholipid antibodies have a higher risk of recurrent thrombosis than do patients without antiphospholipid antibodies. 1 Retrospective studies suggest that patients with antiphospholipid antibodies have a high risk of recurrent thrombosis while receiving moderate-intensity warfarin (target international normalized ratio [INR], 2.0 to 3.0) and that this risk is lower with a higher intensity of anticoagulant therapy (target INR, 3.1 to 4.5). 2 – 4 However, these results must be interpreted with caution, because the studies were retrospective case . . .