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Connective tissue diseases

The conundrum of B cell depletion in SLE

Nature Reviews Rheumatology volume 5, pages 304–305 (2009)Cite this article

Two consecutive trials of rituximab, a B-cell-depleting anti-CD20 monoclonal antibody, have threatened the future of B-cell-targeted therapy for systemic lupus erythematosus (SLE). While rumors of the demise of this approach might be greatly exaggerated, the outcomes of these studies should force academics and the pharmaceutical industry back to the drawing board.

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Figure 1: B cell diversity and homeostasis in SLE.

References

  1. Phase III study of rituxan in lupus nephritis did not meet primary endpoint [online] (2009).

  2. Isenberg, D., Gordon, C., Merrill, J. & Urowitz, M. New therapies in systemic lupus erythematosus—trials, troubles and tribulations... Working towards a solution. Lupus 17, 967–970 (2008).

    Article  CAS  Google Scholar 

  3. Wallace, D. New therapies in systemic lupus erythematosus—trials, troubles and tribulations—working towards a solution: part 2—the politically incorrect version. Lupus 18, 101–103 (2009).

    Article  CAS  Google Scholar 

  4. Waldman, M. & Appel, G. B. Update on the treatment of lupus nephritis. Kidney Int. 70, 1403–1412 (2006).

    Article  CAS  Google Scholar 

  5. Merrill, J. T. et al. Efficacy and safety of rituximab in patients with moderately to severely active systemic lupus erythematosus (SLE): results from the randomized, double-blind phase II/III study EXPLORER [abstract L12]. Presented at the American College of Rheumatology Annual Meeting, 2008 October 24–29, San Francisco, CA.

  6. Melander, C. et al. Rituximab in severe lupus nephritis: early B-cell depletion affects long-term renal outcome. Clin. J. Am. Soc. Nephrol. 4, 579–587 (2009).

    Article  CAS  Google Scholar 

  7. Anolik, J. H. et al. Delayed memory B cell recovery in peripheral blood and lymphoid tissue in systemic lupus erythematosus after B cell depletion therapy. Arthritis Rheum. 56, 3044–3056 (2007).

    Article  CAS  Google Scholar 

  8. Manjarrez-Orduno, N., Quach, T. D. & Sanz, I. B cells and immunological tolerance. J. Invest. Dermatol. 129, 278–288 (2009).

    Article  CAS  Google Scholar 

  9. Dorner, T. & Lipsky, P. E. Correlation of circulating CD27high plasma cells and disease activity in systemic lupus erythematosus. Lupus 13, 283–289 (2004).

    Article  CAS  Google Scholar 

  10. Dass, S. et al. Highly sensitive B cell analysis predicts response to rituximab therapy in rheumatoid arthritis. Arthritis Rheum. 58, 2993–2999 (2008).

    Article  CAS  Google Scholar 

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  1. I. Sanz, Division of Clinical Immunology & Rheumatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 695, Rochester, NY 14642, USA ignacio_sanz@urmc.rochester.edu

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  1. Division of Clinical Immunology & Rheumatology, University of Rochester Medical Center, Rochester, NY, USA

    Iñaki Sanz

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  1. Iñaki Sanz
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The author has acted as a consultant for Genentech, limited to attending a B cell summit meeting.

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Sanz, I. The conundrum of B cell depletion in SLE. Nat Rev Rheumatol 5, 304–305 (2009). https://doi.org/10.1038/nrrheum.2009.100

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