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Publication Detail
B cell depletion therapy in systemic lupus erythematosus: long-term follow-up and predictors of response.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Ng KP, Cambridge G, Leandro MJ, Edwards JCW, Ehrenstein M, Isenberg DA
  • Publication date:
    09/2007
  • Pagination:
    1259, 1262
  • Journal:
    Ann Rheum Dis
  • Volume:
    66
  • Issue:
    9
  • Status:
    Published
  • Country:
    England
  • Print ISSN:
    0003-4967
  • PII:
    ard.2006.067124
  • Language:
    eng
  • Keywords:
    Adult, Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Antirheumatic Agents, B-Lymphocytes, Biomarkers, Complement C3, Cyclophosphamide, Female, Follow-Up Studies, Health Status Indicators, Humans, Logistic Models, Lupus Erythematosus, Systemic, Lymphocyte Depletion, Male, Middle Aged, Recurrence, Risk, Rituximab, Time
Abstract
OBJECTIVES: To describe the long-term clinical outcome and safety profile of B cell depletion therapy (BCDT) in patients with systemic lupus erythematosus (SLE). It was also determined whether baseline parameters can predict the likelihood of disease flare. METHODS: 32 patients with refractory SLE were treated with BCDT using a combination protocol (rituximab and cyclo-phosphamide). Patients were assessed with the British Isles Lupus Assessment Group (BILAG) activity index, and baseline serology was measured. Flare was defined as a new BILAG 'A' or two new subsequent 'B's in any organ system. RESULTS: Of the 32 patients, 12 have remained well after one cycle of BCDT (median follow-up 39 months). BCDT was followed by a decrease of median global BILAG scores from 13 to 5 at 6 months (p = 0.006). Baseline anti-extractable nuclear antigen (ENA) was the only identified independent predictor of flare post-BCDT (p = 0.034, odds ratio = 8, 95% CI 1.2 to 55) from multivariable analysis. Patients with low baseline serum C3 had a shorter time to flare post-BCDT (p = 0.008). Four serious adverse events were observed. CONCLUSION: Autoantibody profiling may help identify patients who will have a more sustained response. Although the long-term safety profile of BCDT is favourable, ongoing vigilance is recommended.
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