B-Cell Depletion May Be Helpful in Lupus

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B-Cell Depletion May Be Helpful in Lupus

Laurie Barclay, MD

Oct. 7, 2002 - B-cell depletion may be a viable treatment strategy in

systemic lupus erythematosus (SLE), according to the results of a small

open-label study in the October issue of Arthritis & Rheumatism.

" This study provides sufficient evidence to justify a formal controlled

trial, " lead author J. Leandro, from University College in London,

U.K., says in a news release.

Study subjects were six women fulfilling at least four of the current

American College of Rheumatology criteria for SLE and ranging in age

from 17 to 40 years. Treatment given over a two-week period consisted of

two 750-mg infusions of cyclophosphamide, high-dose oral prednisolone,

and two 500-mg infusions of rituximab, a B-cell targeted monoclonal

antibody proven highly effective against B-cell lymphomas.

One patient did not improve after treatment and was lost to three-month

follow-up. At six months, the remaining five women improved

significantly in British Isles Lupus Assessment Group global scores.

Improvements included decreased fatigue, joint inflammation and

serositis; decreased or stable sedimentation rate; increased hemoglobin

in four patients; and improved renal and pulmonary function. B

lymphocyte levels remained low in all subjects between three and six

months, and treatment was well tolerated with no major adverse effects.

" B lymphocyte depletion using rituximab has been introduced for the

treatment of several autoimmune disorders, including rheumatoid

arthritis, IgM-associated neuropathies, and immune thrombocytopenia,

with encouraging early results, " the authors write.

Arthritis Rheum. 2002;46:2673-2677

Reviewed by D. Vogin, MD

http://www.medscape.com/viewarticle/442547