RESEARCH - New approaches of B-cell-directed therapy: beyond rituximab

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From Current Opinion in Rheumatology

Posted 12 Jun 2008

Dörner; Gerd R. Burmester

New Approaches of B-Cell-Directed Therapy: Beyond Rituximab

Abstract

Purpose of review: This study reviews therapeutic approaches of direct

and indirect B-cell targeting in autoimmune diseases and their impact

on protective immunity.

Recent findings: Beyond recent clinical experiences with rituximab as

B-cell-depleting agent, other biologicals targeting CD20, such as

ocrelizumab, ofatumumab, hA20, and TRU-015 mainly deplete B cells and

are under clinical investigation in different entities. Moreover,

anti-CD22 targeting as another approach that has been studied in

clinical trials showed a modest depletion, but inhibition of B-cell

activation. More indirect innovative B-cell-affecting therapies

comprise blockade of cytokines, such as B-cell-activating factor

(BAFF/BLyS), APRIL, and their receptors as well as blockade of

costimulation. Although decreases of immunoglobulin levels were seen,

so far no major increases in infections were reported.

Summary: The value of certain B-cell-depletion therapies as well as

other therapies modulating B-cell functions needs to be further

delineated, especially in the therapeutic regimen of rheumatoid

arthritis, specific collagen vascular diseases and vasculitis.

Long-term observations of protective immunity are also needed to

further evaluate the rate of infections.

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Read the entire article here:

http://www.medscape.com/viewarticle/573651

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Not an MD