Improving B-cell depletion in systemic lupus erythematosus and rheumatoid arthritis

被引：20

作者：

Mota, Pedro ^{[1
]}

Reddy, Venkat ^{[2
]}

Isenberg, David ^{[2
]}

机构：

[1] Hosp Luz, Dept Internal Med, Lisbon, Portugal

[2] UCL, Div Med, Ctr Rheumatol, London, England

来源：

EXPERT REVIEW OF CLINICAL IMMUNOLOGY | 2017年 / 13卷 / 07期

关键词：

B-cell depletion; SLE; RA; lupus nephritis; B-cell biology; ANTI-CD20; MONOCLONAL-ANTIBODY; LYMPHOCYTE STIMULATOR; DOUBLE-BLIND; RITUXIMAB; THERAPY; NEPHRITIS; EFFICACY; MECHANISMS; DISEASE; SAFETY;

D O I：

10.1080/1744666X.2017.1259068

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

071005 [微生物学]; 100108 [医学免疫学];

摘要：

Introduction: Rituximab-based B-cell depletion (BCD) therapy is effective in refractory rheumatoid arthritis (RA) and although used to treat patients with refractory systemic lupus erythematosus (SLE) in routine clinical practice, rituximab failed to meet the primary endpoints in two large randomised controlled trials (RCTs) of non-renal (EXPLORER) and renal (LUNAR) SLE.Areas covered: We review how BCD could be improved to achieve better clinical responses in RA and SLE. Insights into the variability in clinical response to BCD in RA and SLE may help develop new therapeutic strategies. To this end, a literature search was performed using the following terms: rheumatoid arthritis, systemic erythematosus lupus, rituximab and B-cell depletion.Expert commentary: Poor trial design may have, at least partly, contributed to the apparent lack of response to BCD in the two RCTs of patients with SLE. Enhanced B-cell depletion and/or sequential therapy with belimumab may improve clinical response at least in some patients with SLE

引用

页码：667 / 676

页数：10

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