ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0527

Rituximab for Refractory Manifestations of the Antiphospholipid Syndrome: A Multicenter Israeli Experience

Nancy Agmon-Levin1, Mark Berman2, Liora Harel3, Merav Lidar4, Soad Hajyahia1 and Daphna Paran5, 1Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel, 2Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, 3Scheider Children's Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel, Petach Tikva, Israel, 4Rheumatology unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Hod Hasharon, Israel, 5Department of Rheumatology, Tel Aviv Medical Center, Tel Aviv, Israel

Meeting: ACR Convergence 2020

Keywords: , , ,

Session Information

Date: Saturday, November 7, 2020

Title: Antiphospholipid Syndrome Poster

Session Type: Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The clinical manifestations of the antiphospholipid syndrome (APS) are heterogeneous and related to anti-phospholipid antibodies (aPL). There is some evidence that B cells are involved in the pathogenesis of this condition. Thus the ability of rituximab (RTX) to deplete B cells makes it an appealing potential therapy for refractory antiphospholipid syndrome (APS). Real world data on RTX treatment of APS is still lacking. This study was conducted to report outcomes of RTX administration in the treatment of different aspects of APS.

Methods: This is a retrospective case series study on APS patients from 3 medical centers in Israel who were treated with RTX during 2010-2019 for refractory manifestations of APS including diffuse alveolar hemorrhage, recurrent thrombosis, thrombocytopenia, neurological and skin manifestations. Medical records were reviewed regarding the clinical indication for RTX treatment, concomitant medications, RTX protocol, aPL status and response to treatment. Outcomes were defined as complete response if full resolution of the “indicated manifestation” was achieved and maintained for at least 12 months, partial response or no response

Results: We identified 40 patients who were treated with RTX for refractory APS, 31 patients had primary APS (78%), 24 (60%) were female, mean age was 40 years.  A favorable response to RTX was documented in 32 patients (80%) including complete response in 22 (55%). A RTX regimen of 375mg/m2 X 4 was more effective than a regimen of 1000 mgx2 (100% vs. 65%; p=0.01).

Complete response was associated with a decrease in aPL titers 4-6 months post treatment. No significant change in aPL titers was observed in patients with partial or no response.

Conclusion: Consistent with previous small case series, we report a good therapeutic response to RTX in patients with difficult to treat manifestations of APS. In this cohort, treatment protocols were associated with outcomes. Although further studies are required to verify our observations, our data support a plausible role for B cell depletion in refractory APS.

Disclosure: N. Agmon-Levin, None; M. Berman, None; L. Harel, None; M. Lidar, None; S. Hajyahia, None; D. Paran, None.

To cite this abstract in AMA style:

Agmon-Levin N, Berman M, Harel L, Lidar M, Hajyahia S, Paran D. Rituximab for Refractory Manifestations of the Antiphospholipid Syndrome: A Multicenter Israeli Experience [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/rituximab-for-refractory-manifestations-of-the-antiphospholipid-syndrome-a-multicenter-israeli-experience/. Accessed .

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/rituximab-for-refractory-manifestations-of-the-antiphospholipid-syndrome-a-multicenter-israeli-experience/