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Review
. 2019 Dec 6;2019(1):426-432.
doi: 10.1182/hematology.2019000073.

Is there a role for immunosuppression in antiphospholipid syndrome?

Ecem Sevim  1 , Rohan Willis  2 , Doruk Erkan  3
Affiliations
Review

Is there a role for immunosuppression in antiphospholipid syndrome?

Ecem Sevim et al. Hematology Am Soc Hematol Educ Program. .

Abstract

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy morbidity, or nonthrombotic manifestations in patients with persistently positive antiphospholipid antibodies (aPL). Conventional APS treatment focuses on antithrombotic strategies, which are usually ineffective for the microvascular and nonthrombotic manifestations of aPL. Using a case-based presentation, this review focuses on the role of immunosuppression in nonobstetric APS, including B-cell inhibition (rituximab, belimumab, and bortezomib), complement inhibition (eculizumab), mechanistic target of rapamycin inhibition (sirolimus), vascular endothelial cell modulation (defibrotide), statins, and traditional rheumatologic disease-modifying agents (hydroxychloroquine, mycophenolate mofetil, azathioprine, and cyclophosphamide).

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Conflict of interest statement

Conflict-of-interest disclosure: D.E. received research grants from American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), Lupus Clinical Trials Consortium, and National Institutes of Health; is a clinical research investigator for GSK-sponsored studies; and is a consultant for GSK, UCB, and Exagen. E.S. and R.W. declare no competing financial interests.

References

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