Cambridge G et al. - Patients with SLE with an expanded autoantibody profile and raised serum B lymphocyte stimulator (BLyS) levels at baseline had shorter clinical responses to B cell depletion therapy (BCDT). Methods
Aim was to assess the relationships between BLyS levels, autoantibody profile and clinical response in pts with SLE following rituximab-based BCDT
25 pts with active refractory SLE were followed for ≥1 year following BCDT
Disease activity was assessed using BILAG system, and serum levels of BLyS and abs to dsDNA and extractable nuclear antigens (ENA) measured by ELISA
Serum immunoglobulins and anti-dsDNA abs were assessed for expression of the 9G4 idiotope
Results
Following BCDT, all pts depleted in the peripheral blood and improved clinically for ≥3 mos
Pre-BCDT BLyS levels were quantifiable in 18/25 pts and rose in most pts at 3 mos post-BCDT
9 pts, all with quantifiable pre-BCDT serum BLyS, experienced a disease flare within 1 yr
This group of pts was more likely to harbour anti-Ro/SSA abs with higher serum levels
Serum levels of anti-ribonucleoprotein (RNP)/Sm were also higher in this group
Expression of VH4–34 by serum immunoglobulins and anti-dsDNA antibodies had no predictive value for the length of clinical response
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