Combined therapy with anticoagulation and glucocorticoids plus plasma exchange and/or intravenous immunoglobulins improves the survival rate of patients with catastrophic antiphospholipid syndrome (APS), according to data from an international registry. Triple therapy was associated with a higher chance of survival in comparison with treatment with other combinations of the drugs included in the triple therapy (adjusted OR 1.7, 95% CI 1.2–2.6) or treatment with none of those drugs (adjusted OR 9.7, 95% CI 2.3–40.6).