An update on the biologics for the treatment of antiphospholipid syndrome

Zelin Yun; Lizhi Duan; Xiangjun Liu; Qingmeng Cai; Chun Li

doi:10.3389/fimmu.2023.1145145

An update on the biologics for the treatment of antiphospholipid syndrome

Front Immunol. 2023 May 19:14:1145145. doi: 10.3389/fimmu.2023.1145145. eCollection 2023.

Authors

Zelin Yun^{1

2}, Lizhi Duan³, Xiangjun Liu^{1

2}, Qingmeng Cai^{1

2}, Chun Li^{1

2}

Affiliations

¹ Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
² Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China.
³ Department of Rheumatology and Immunology, Gangkou Hospital of Hebei Port Group Company Limited, Qinhuangdao, Hebei, China.

Abstract

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and pregnancy morbidity with the persistent presence of antiphospholipid antibodies (aPLs). Although anticoagulation is the primary treatment for APS, it fails in approximately 20-30% of obstetric APS cases and more than 30% of thrombotic APS cases. Therefore, there is a need for new, targeted treatments beyond anticoagulants. Biologics, such as rituximab and eculizumab, have been recommended for refractory catastrophic APS. This review focuses on the recent advancements in the pathogenesis of APS and explores the potential of targeted treatments, including eculizumab, rituximab, belimumab, daratumumab, obinutuzumab, and anti-TNF-α antibodies, for APS management.

Keywords: anti-TNF-α antibodies; antiphospholipid syndrome; belimumab; biologics; daratumumab; eculizumab; obinutuzumab; rituximab.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Antiphospholipid
Antiphospholipid Syndrome*
Biological Products* / therapeutic use
Female
Humans
Pregnancy
Rituximab / therapeutic use
Thrombosis* / drug therapy
Thrombosis* / etiology
Tumor Necrosis Factor Inhibitors

Substances

Rituximab
Biological Products
Tumor Necrosis Factor Inhibitors
Antibodies, Antiphospholipid

Grants and funding

This work was supported in part by the China International Medical Foundation (No. Z-2018-40-2101) and the Beijing Municipal Science and Technology Projects (No. Z191100006619110).