TO THE EDITOR:

Complement has been identified as a critical pathway for the development of obstetrical manifestations of the antiphospholipid syndrome (APS) and its life-threatening variant, catastrophic APS (CAPS).1-4  We read with great interest the recently published study by Chaturvedi and colleagues that added important new insights into the understanding of complement involvement in CAPS. Researchers have reported a genetic susceptibility in CAPS patients, with mutations in complement-regulating proteins that may explain the uncontrolled complement activation that triggers thrombotic storms. To date, long-term anticoagulation is the sole nonspecific treatment that has demonstrated efficacy in APS. Additional therapies, such as plasma exchange (PE), intravenous immunoglobulin, and corticosteroids are proposed to treat CAPS.5,6  Despite this standard treatment, CAPS is still associated with significant mortality (up to 30% in the last update of the international CAPS registry). Eculizumab, a monoclonal...

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