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Publication Detail
B lymphocyte depletion in rheumatoid arthritis: targeting of CD20.
  • Publication Type:
    Chapter
  • Authors:
    Edwards JCW, Leandro MJ, Cambridge G
  • Publication date:
    01/2005
  • Pagination:
    175, 192
  • Volume:
    8
  • Medium:
    Print
  • Status:
    Published
  • Language:
    eng
  • Keywords:
    B-Lymphocytes, Humans, Arthritis, Rheumatoid, Cyclophosphamide, Methotrexate, Adrenal Cortex Hormones, Antigens, CD20, Antibodies, Monoclonal, Rheumatoid Factor, Lymphocyte Depletion, Combined Modality Therapy, Models, Immunological, Antibodies, Monoclonal, Murine-Derived, Rituximab
  • Addresses:
    Centre for Rheumatology, University College London, London, UK. jo.edwards@ucl.ac.uk
Abstract

Background

During the 1990s evidence emerged to suggest that B lymphocyte depletion in rheumatoid arthritis (RA) might be of major benefit.

Methods and results

In 1997 the B lympholytic monoclonal anti-CD20 antibody rituximab became available. Significant clinical efficacy has been demonstrated in RA, initially in open studies at University College London and recently in a multicentre randomised controlled trial. Forty RA patients at University College London have now received in total 75 treatment cycles with rituximab (up to 4 individually) alone or in combination with corticosteroid, cyclophosphamide and/or methotrexate. Ongoing immunodynamic studies of these patients have shed light on a number of questions about both the therapeutic potential of B cell targeting, and the pathogenesis of RA.

Conclusions

The effects of B lymphocyte depletion lend increasing support to the idea that both the inflammatory effector mechanism and the underlying immunoregulatory disturbance in RA are driven by autoantibody rather than T cells.
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