Lupus & antiphospholipid syndrome
Assessment of the use of biologic drugs in the treatment of primary antiphospholipid syndrome
Authors' conclusion
Biologic therapies may represent valuable adjunctive options for specific APS phenotypes, especially refractory or complement-driven cases.
Study context
- Population
- Adults with primary APS (pAPS) or catastrophic APS (CAPS) treated with biologics50 publications · >100 patients
- Comparison
- Rituximab, eculizumab, belimumab or daratumumab in pAPS or CAPS
- Outcome
- Clinical efficacy, safety and immunological effects of biologic therapies
Methodological detailsPubMed and Embase, January 2005-January 2025
- PubMed and Embase, January 2005-January 2025
Pooled result
As reported in the abstract
- Rituximab: most frequently used; substantial efficacy in haematologic and cutaneous manifestations (thrombocytopenia, livedoid vasculopathy); limited impact on aPL levels
- Eculizumab: effective in complement-mediated presentations (thrombotic microangiopathy (TMA), thrombocytopenia, renal involvement); minimal serological changes
- Belimumab: clinical and serologic improvement in select high-risk individuals
- Daratumumab: temporarily reduced aPL titres in a single refractory case
Original publication
Assessment of the use of biologic drugs in the treatment of primary antiphospholipid syndrome. Rheumatology (Oxford). Published 30 March 2026. doi:10.
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