Rituximab anti-B-cell therapy in systemic lupus erythematosus: pointing to the future.
Purpose Of Review: To discuss the clinical effects and the immunologic consequences of transient B-cell depletion using the anti-CD20 monoclonal antibody rituximab in systemic lupus erythematosus.Recent Findings: A total of 100 rituximab-treated patients with severe disease, refractory to major immu...
| Publicado en: | Current Opinion in Rheumatology Vol. 17; no. 5; pp. 550 - 558 |
|---|---|
| Autores principales: | , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Sep2005
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138711002&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138711002 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10408711 IR0 jtl: Current Opinion in Rheumatology issn: 10408711 maglogo: N pubinfo: dt: Sep2005 vid: 17 iid: 5 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 138711002 138711002 NLM16093832 138711002 10.1097/01.bor.0000172798.26249.fc NLM16093832 138711002 ppf: 550 ppct: 8 formats: tig: atl: Rituximab anti-B-cell therapy in systemic lupus erythematosus: pointing to the future. aug: au: Sfikakis, Petros P Boletis, John N Tsokos, George C affil: First Department of Propedeutic and Internal Medicine, Athens University Medical School, Greece sug: subj: B Lymphocytes Immunology Immunologic Factors Therapeutic Use Lupus Erythematosus, Systemic Immunology Antibodies, Monoclonal Therapeutic Use Lupus Erythematosus, Systemic Drug Therapy Antibodies, Monoclonal Human Scales ab: Purpose Of Review: To discuss the clinical effects and the immunologic consequences of transient B-cell depletion using the anti-CD20 monoclonal antibody rituximab in systemic lupus erythematosus.Recent Findings: A total of 100 rituximab-treated patients with severe disease, refractory to major immunosuppressive treatment, have been reported so far. Within a median follow-up period of 12 months rituximab was well tolerated, which is compatible with the experience accumulated from its use in more than 500 000 lymphoma patients. About 80% of patients achieved marked and rapid reductions in global disease activity. Because of the clinical heterogeneity, dosing differences, and concomitant treatments, including cyclophosphamide in 35% of patients, a proper evaluation of the clinical efficacy or rituximab is difficult. Variable degrees of clinical benefit have been reported for all clinical systemic lupus erythematosus manifestations, including active proliferative nephritis. Whereas 4-weekly infusions of 375 mg/m of rituximab result in complete B-cell depletion lasting most often from 3 to 8 months, a prolonged depletion does not always correlate with a more favorable clinical response. Total immunoglobulin levels and protective antibodies are preserved, but anti-dsDNA antibody titers decrease, often independently of the clinical response.Summary: The findings reviewed point to a growing optimism for targeting B cells in the treatment of systemic lupus erythematosus; therefore double-blind studies comparing rituximab with existing immunosuppressive therapies are needed. Moreover, careful assessments of the effects of transient B-cell depletion on distinct autoimmune pathogenetic processes will enable optimization of therapeutic single or combined therapeutic schemes. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|