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

Mota, P; Reddy, V; Isenberg, D; (2017) Improving B-cell depletion in systemic lupus erythematosus and rheumatoid arthritis. Expert Review of Clinical Immunology , 13 (7) pp. 667-676. 10.1080/1744666X.2017.1259068. Green open access

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Abstract

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.

Type: Article
Title: Improving B-cell depletion in systemic lupus erythematosus and rheumatoid arthritis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/1744666X.2017.1259068
Publisher version: http://dx.doi.org/10.1080/1744666X.2017.1259068
Language: English
Additional information: Copyright © 2016 Informa UK Limited, trading as Taylor & Francis Group. This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Clinical Immunology on 25 November 2016, available online: http://dx.doi.org/10.1080/1744666X.2017.1259068
Keywords: B-cell biology, B-cell depletion, RA, SLE, lupus nephritis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/1536412
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