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Publication Detail
Sustained improvement in rheumatoid arthritis following a protocol designed to deplete B lymphocytes
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Edwards JC, Cambridge G
  • Publication date:
    02/2001
  • Pagination:
    205, 211
  • Journal:
    Rheumatology
  • Volume:
    40
  • Issue:
    2
  • Print ISSN:
    1462-0324
  • Keywords:
    1217, adult, ADVERSE, adverse effects, adverse events, American, anti-CD20, antibodies, Antibody, Arthritis, Arthritis, Rheumatoid, B Lymphocyte, B-lymphocyte, B-Lymphocytes, clinical, Clinical Protocols, Clinical trial, CLINICAL-TRIAL, College, CRITERIA, Cyclophosphamide, DEPLETION, disease, EPISODE, EPISODES, EVENTS, Female, HYPOTHESIS, IM, immunology, IMPROVEMENT, LA, LEVEL, LYMPHOCYTE, Lymphocyte Depletion, Lymphocytes, May, Methods, Middle Age, Open, Patient, patients, Prednisolone, Protocol, RELAPSE, Remission Induction, RESPIRATORY, Result, Retreatment, Rheumatoid arthritis, Rheumatoid Factor, RHEUMATOID-ARTHRITIS, Rheumatology, SAFE, Support, Non-U.S.Gov't, THERAPIES, therapy, Thrombocytopenia, treatment, Treatments, TRIAL
  • Notes:
    UI - 21157847 LA - eng PT - Clinical Trial PT - Journal Article DA - 20010321 IS - 1462-0324 SB - IM CY - England
Abstract
OBJECTIVES: An open study of B-lymphocyte depletion was undertaken in rheumatoid arthritis (RA) patients to test the hypothesis that B lymphocytes may be essential to disease perpetuation. METHODS: Five patients with refractory RA were treated with a monoclonal anti-CD20 antibody, cyclophosphamide and prednisolone and followed for 12-17 months. Patient 2 received further treatments at 8 and 12 months and patient 4 at 11 months. RESULTS: At 26 weeks all patients satisfied the American College of Rheumatology ACR50 and patients 1-3 the ACR70 criteria of improvement, without further therapy. Patients 1, 3 and 5 achieved ACR70 at 1 yr and rheumatoid factor (RF) levels fell to normal. In patients 3 and 5, B lymphocytes returned without relapse. Patient 2 relapsed at 28 weeks and patient 4 at 38 weeks, coincident with the return of B lymphocytes in the presence of raised RF levels. Both achieved ACR70 on retreatment. Adverse events were limited to respiratory episodes (two patients) and marginal thrombocytopenia (one patient). CONCLUSIONS: These findings are consistent with the concept that RA is critically dependent on B lymphocytes and suggest that B- lymphocyte depletion may be a safe and effective therapy
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