title: Rituximab usage in systemic lupus erythematosus-associated antiphospholipid syndrome: A single-center experience.
abstract: Although the data from primary antiphospholipid syndrome (APS) suggests a beneficial effect of rituximab usage, its therapeutic role remains to be defined in systemic lupus erythematosus (SLE)-associated APS, a complex clinical situation with thrombotic events and lupus activity.
  
  
  
  A single-center retrospective analysis of rituximab usages in APS was performed in 800 hospitalized SLE patients.
  
  
  
  There were 63 SLE-associated APS cases with 6 on rituximab therapy, all female aged 37.7 ± 9.0 years with 1 catastrophic and 16 thrombotic episodes. Therapeutic indications included warfarin failure despite the adequate target international normalized ratio with an average duration of 17.3 ± 11.2 months between the thrombotic recurrences. After the rituximab therapy, there was no relapse of thrombosis with a mean follow-up period of 39.3 ± 20.9 months, and a decrease in lupus activity (SLEDAI-2K, 9.7 ± 5.5 to 5.3 ± 2.2). Infection complications were observed, including episodes of bronchitis and urinary tract infection.
  
  
  
  In this single-center study with largest case numbers and a long-term follow-up period, there were no recurrent thrombotic events after the rituximab therapy, implicating further consideration of large-scale trials enrolling more ethnic groups to evaluate its therapeutic role in SLE-associated APS patients.
authors.affiliation: Department of Internal Medicine, Section of Rheumatology and Immunology, National Cheng Kung University Hospital, Tainan, Taiwan. Electronic address: wangcr@mail.ncku.edu.tw.
authors.forename: Chrong-Reen
authors.initials: CR
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, Section of Rheumatology and Immunology, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ming-Fei
authors.initials: MF
authors.lastname: Liu
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000069283:Rituximab
keywords: Antiphospholipid syndrome; Rituximab; Systemic lupus erythematosus