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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 …
Handling editor Josef S Smolen
YY and CS contributed equally.
Contributors YY collected the data and participated in follow-ups. CS provided the figure and wrote the manuscript. ZZ performed statistical analysis. FW and YSun collected the clinical data at baseline. JT and H-LL helped to prepare the table. XC accessed the disease activity of patients with APS. YSu revised the manuscript. HS helped to the follow-ups. CY designed, participated in follow-ups. JY designed the study, contributed to the discussion and revised the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the National Natural Science Foundation of China (No. 81801592) and Shanghai Sailing Programme (18YF1414100), Clinical Research Plan of SHDC (SHDC2020CR4011).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.