I read with much interest the article of Derksenet al in the January issue of theAnnals of the Rheumatic Diseases.1 The authors gave a detailed introduction to the difficult field of treatment of pregnant patients with antiphospholipid syndrome (APS). Despite the presence of only a limited amount of data from controlled studies the authors gave helpful recommendations for the daily management of these patients.

However, there is a major concern with which I would like to deal. As we know the success of treatment of APS with oral anticoagulants very much depends on the strictness with which the dose is adjusted to the …