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See Latest ArticlesB cell depletion in lupus and Sjogrens syndrome: An update
Current Opinion in Rheumatology, 08/18/09
Coca A et al. – Study reports that despite the disappointing results of 2 phase III trials, other evidence continues to be published in support of the notion that B cell depletion could be useful for patients with refractory disease, including lupus nephritis, and antibody-mediated cytopenias, possibly in combination with other immunosuppressant medication.
Methods- Review summarizes recent advances in the field of B cell depletion in SLE and Sjögren's syndrome
- Reports of successful B cell depletion therapy in refractory SLE are on the rise
- In contrast, 2 phase III trials employing B cell depletion with rituximab in nonlupus and lupus nephritis (Explorer and Lunar, respectively) did not achieve any success
- Multiple reasons, including:
- Trial design
- Limitations of outcome instruments and sort follow-up
- have been invoked to explain these disconcerting results
- In the representative studies addressing B cell depletion complete and partial remission in lupus nephritis has been achieved in 60-89% of cases
- Improvements in BILAG and SLEDAI scores were associated with decrease in anti-dsDNA and increase in complement levels
- B cell depletion seemed quite efficacious also in pediatric SLE
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