Subscribe to RSS
The Effect of Rituximab on Antiphospholipid Titers in Patients with Antiphospholipid SyndromeFunding K.Y. is supported by the National Heart, Lung, and Blood Institute, National Institute of Health grant T32HL007149-44.
Rituximab in patients with antiphospholipid syndrome (APS) is mostly used for treating noncriteria APS manifestations such as thrombocytopenia, and is not a first- or second-line treatment for management of thrombosis. However, at times rituximab is used empirically as adjunct treatment in patients with recurrent thrombosis occurring in spite of anticoagulant therapy (i.e., anticoagulation failure) when combinations of increased anticoagulation intensity, addition of antiplatelet therapy, and reduction of all thrombotic risk factors fail to prevent recurrent thrombosis.  Knowledge of its effect on the naturally fluctuating antiphospholipid antibody (APLA) titers is, however, limited. We sought to determine the effect of rituximab on decreasing the magnitude and type of APLA in patients with thrombotic APS.
K.Y. designed the study, collected the data, and was involved in the data analysis, and wrote the manuscript. S.M. designed the study and oversaw the manuscript, data collection, and analysis and manuscript writing.
H.H. performed the statistical analysis; A.D. oversaw the statistical analysis.
Received: 13 January 2023
Accepted: 21 April 2023
Article published online:
05 July 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Kumar D, Roubey RA. Use of rituximab in the antiphospholipid syndrome. Curr Rheumatol Rep 2010; 12 (01) 40-44
- 2 Arachchillage DRJ, Laffan M. Pathogenesis and management of antiphospholipid syndrome. Br J Haematol 2017; 178 (02) 181-195
- 3 Erkan D, Vega J, Ramón G, Kozora E, Lockshin MD. A pilot open-label phase II trial of rituximab for non-criteria manifestations of antiphospholipid syndrome. Arthritis Rheum 2013; 65 (02) 464-471
- 4 Agmon-Levin N, Berman M, Harel L. et al. Rituximab for refractory manifestations of the antiphospholipid syndrome: a multicentre Israeli experience. Clin Exp Rheumatol 2021; 39 (05) 1049-1055
- 5 Berman H, Rodríguez-Pintó I, Cervera R. et al; Catastrophic Antiphospholipid Syndrome (CAPS) Registry Project Group (European Forum on Antiphospholipid Antibodies). Rituximab use in the catastrophic antiphospholipid syndrome: descriptive analysis of the CAPS registry patients receiving rituximab. Autoimmun Rev 2013; 12 (11) 1085-1090
- 6 Sciascia S, Naretto C, Rossi D, Bazzan M, Roccatello D. Treatment-induced downregulation of antiphospholipid antibodies: effect of rituximab alone on clinical and laboratory features of antiphospholipid syndrome. Lupus 2011; 20 (10) 1106-1108
- 7 Pengo V, Biasiolo A, Gresele P. et al. A comparison of lupus anticoagulant-positive patients with clinical picture of antiphospholipid syndrome and those without. Arterioscler Thromb Vasc Biol 2007; 27 (12) e309-e310
- 8 Sevim E, Willis R, Erkan D. Is there a role for immunosuppression in antiphospholipid syndrome?. Hematology (Am Soc Hematol Educ Program) 2019; 2019 (01) 426-432
- 9 Erdozain JG, Ruiz-Irastorza G, Egurbide MV, Aguirre C. Sustained response to rituximab of autoimmune hemolytic anemia associated with antiphospholipid syndrome. Haematologica 2004; 89 (09) ECR34
- 10 Ahn ER, Lander G, Bidot CJ, Jy W, Ahn YS. Long-term remission from life-threatening hypercoagulable state associated with lupus anticoagulant (LA) following rituximab therapy. Am J Hematol 2005; 78 (02) 127-129
- 11 Anandacoomarasamy A, Gibson J, McGill N. ‘Cure’ of life-threatening antiphospholipid syndrome with rituximab. Intern Med J 2006; 36 (07) 474-475
- 12 Ames PR, Tommasino C, Fossati G, Scenna G, Brancaccio V, Ferrara F. Limited effect of rituximab on thrombocytopaenia and anticardiolipin antibodies in a patient with primary antiphospholipid syndrome. Ann Hematol 2007; 86 (03) 227-228
- 13 Adamson R, Sangle S, Kaul A, Hughes GR, D'Cruz DP. Clinical improvement in antiphospholipid syndrome after rituximab therapy. J Clin Rheumatol 2008; 14 (06) 359-360
- 14 Tsagalis G, Psimenou E, Nakopoulou L, Laggouranis A. Effective treatment of antiphospholipid syndrome with plasmapheresis and rituximab. Hippokratia 2010; 14 (03) 215-216