Baseline autoantibody profiles predict normalization of complement and anti-dsDNA autoantibody levels following rituximab treatment in systemic lupus erythematosus
| Autor: | Hsieh Hj, John G. Monroe, Kristen Wolslegel, Rabbee N, Timothy W. Behrens, Gaik W. Tew, Mary E. Keir, Paul Brunetta |
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| Rok vydání: | 2009 |
| Předmět: |
Antibodies
Monoclonal Murine-Derived Rheumatology Double-Blind Method immune system diseases Prednisone medicine Humans Immunologic Factors Lupus Erythematosus Systemic skin and connective tissue diseases B-cell activating factor Autoantibodies Randomized Controlled Trials as Topic CD20 Lupus erythematosus biology business.industry Autoantibody Antibodies Monoclonal RNA-Binding Proteins Complement System Proteins DNA medicine.disease Antibodies Anticardiolipin Monoclonal Immunology biology.protein Rituximab Antibody business Biomarkers medicine.drug Follow-Up Studies |
| Zdroj: | Lupus. 19(2) |
| ISSN: | 1477-0962 |
| Popis: | B cells are thought to play a major role in the pathogenesis of systemic lupus erythematosus (SLE). Rituximab (RTX), a chimeric anti-CD20 mAb, effectively depletes CD20 + peripheral B cells. Recent results from EXPLORER, a placebo-controlled trial of RTX in addition to aggressive prednisone and immunosuppressive therapy, showed similar levels of clinical benefit in patients with active extra-renal SLE despite effective B cell depletion. We performed further data analyses to determine whether significant changes in disease activity biomarkers occurred in the absence of clinical benefit. We found that RTX-treated patients with baseline autoantibodies (autoAbs) had decreased anti-dsDNA and anti-cardiolipin autoAbs and increased complement levels. Patients with anti-dsDNA autoAb who lacked baseline RNA binding protein (RBP) autoAbs showed increased complement and decreased anti-dsDNA autoAb in response to RTX. Other biomarkers, such as baseline BAFF levels or IFN signature status did not predict enhanced effects of RTX therapy on complement or anti-dsDNA autoAb levels. Finally, platelet levels normalized in RTX-treated patients who entered the study with low baseline counts. Together, these findings demonstrate clear biologic activity of RTX in subsets of SLE patients, despite an overall lack of incremental clinical benefit with RTX in the EXPLORER trial. Lupus (2010) 19, 146—157. |
| Databáze: | OpenAIRE |
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