Lupus & antiphospholipid syndrome
Serological and clinical outcomes of rituximab in antiphospholipid syndrome with or without SLE: a retrospective single-centre cohort
Authors' conclusion
Rituximab was associated with marked short-term reductions in aPL titres and positivity, although quantitative suppression was not sustained long term. Changes in aCL/aβ2GPI did not consistently reflect thrombotic risk. These findings suggest that rituximab may be a valuable adjunctive therapy in selected patients with difficult-to-treat APS, although causality cannot be established from this retrospective study.
Study context
- Population
- Patients with APS, predominantly SLE-associated APS, who received at least one course of rituximabpatients who received at least one course of rituximab, long-term serological data available for 31 patients · SLE-associated APS 43
- Participants
- 54 patients
- Outcome
- aCL IgG positivity, baseline to follow-up
- Follow-up
- 6-12 months
Main finding
As reported in the abstract
Positivity rate decreased from 59.3% to 24.1%
59.3% to 24.1%
Observational data: associations, not effects.
Further findings
aCL IgM positivity, baseline to follow-up · 6-12 months
- Positivity rate decreased from 24.1% to 5.6%
- 24.1% to 5.6%
- All P <0.05
aβ2GPI IgG positivity, baseline to follow-up · 6-12 months
- Positivity rate decreased from 42.6% to 16.7%
- 42.6% to 16.7%
- All P <0.05
aβ2GPI IgM positivity, baseline to follow-up · 6-12 months
- Positivity rate decreased from 20.4% to 5.6%
- 20.4% to 5.6%
- All P <0.05
aβ2GPI IgG positivity at last follow-up vs baseline
- aβ2GPI IgG positivity remained lower than baseline
- P = 0.039
- Quantitative titres were no longer significantly different
- Long-term serological data available for 31 patients
Long-term serological changes by rituximab cycle number
- Did not differ according to rituximab cycle number
Thrombotic recurrence · median follow-up 4.7 years
- Patients with thrombotic recurrence
- five
- Of whom (of the five with recurrence) were either off anticoagulation or had subtherapeutic INR values
- four
Safety
Infections and deaths during follow-up · median follow-up 4.7 years
- Patients with bacterial infections
- Fifteen
- SARS-CoV-2 infections
- seven
- Patients died
- five
- Of the deaths, died from sepsis
- one
Original publication
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