Rituximab in thrombotic primary antiphospholipid syndrome: a pilot study from a single centre in China

Antiphospholipid syndrome (APS) is a multisystem disorder defined by a combination of arterial and/or venous thrombosis, recurrent fetal loss in women and persistent presence of antiphospholipid (aPL) antibodies such as lupus anticoagulant (LAC), anti-β2-glycoprotein I (anti-β2GPI) and anticardiolipin antibodies (aCL).1 APS can occur either in primary condition (primary APS, PAPS) or in association with other autoimmune diseases (secondary APS). In terms of the treatment of APS, the first-line therapy consists of low-dose aspirin or low-molecular-weight heparin2 or warfarin, usually it was highly effective, but in a few cases, APS may be refractory. So in the recent years, new emerging treatments have been used, such as hydroxychloroquine, statins, rituximab (RTX), eculizumab and intravenous immunoglobulin.3 RTX is a specific anti-CD20 antibody. Several reports showed the efficacy of RTX in APS, even in catastrophic APS,4 or in combination with SLE and diffuse alveolar haemorrhage,5 or in refractory obstetrical APS.6 In our study, we aimed to describe the efficacy of RTX in six patients with thrombotic PAPS in Department of Rheumatology …