Anticardiolipin and anti-beta 2 glycoprotein-I antibodies disappearance in patients with systemic lupus erythematosus and antiphospholipid syndrome while on belimumab

The current management of antiphospholipid syndrome (APS) centres on attenuating the procoagulant state while balancing the haemorrhagic risks.1 This approach relies mainly on a thromboprophylaxis strategy rather than targeting pathogenic antiphospholipid antibodies (aPL)-mediated pathways. Herewith, we report the aPL disappearance in three patients with APS associated to systemic lupus erythematous (SLE) while on treatment with belimumab, potentially paving the way for development of new targeted therapies for APS. Belimumab is a monoclonal antibody that works by blocking the B-lymphocyte stimulator and avoiding B-cell activation.2 It is the first biological drug approved for the treatment of autoantibody positive SLE in active phase and it has shown its capability to reduce the antibodies levels, including anti-double stranded-DNA.3 Intriguingly, in murine models of APS in the setting of SLE, belimumab …