What is your preferred approach for patients with anti-phospholipid syndrome with recurrent thrombosis on coumadin and LMWH?

This is a difficult condition to manage and personalized approach/risk stratification is key. There are several potential considerations:

Warfarin therapy could be intensified, anti-platelet agents could be considered (although not in combination with LMWH).

For patients with an underlying autoimmune condition (e.g. lupus), treatment changes may be considered.

Statins and hydroxychloroquine are relatively safe medications that could be added.

Alternative explanations for recurrent thrombosis (infect...