B-cell-targeted therapies in systemic lupus erythematosus and ANCA-associated vasculitis: current progress.

Abstract

B cells play a central role in the pathogenesis of systemic lupus erythematosus and anti-neutrophil cytoplasmic antibody-associated vasculitis. There are various strategies for targeting B cells including depletion, inhibition of survival factors, activation and inhibition of co-stimulatory molecules. Controlled trials in systemic lupus erythematosus have shown positive results for belimumab, promising results for epratuzumab and negative results for rituximab. The failure of rituximab in controlled trials has been attributed to trial design, sample size and outcome measures rather than true inefficacy. In anti-neutrophil cytoplasmic antibody-associated vasculitis, rituximab is effective for remission induction and in relapsing disease. However, the optimal long-term re-treatment strategy remains to be determined. Over the next 5 years, evidence will be available regarding the clinical efficacy of these novel therapies, biomarkers and their long-term safety.

• Authors: Md Yuzaiful Md Yusof, Edward M J Vital, Paul Emery
• Journal: Expert review of clinical immunology (Expert Rev Clin Immunol) Vol. 9 Issue 8 Pg. 761-72 (Aug 2013) ISSN: 1744-8409 [Electronic] England
• PMID: 23971754 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antibodies, Monoclonal, Murine-Derived
• B-Cell Activating Factor
• epratuzumab
• Rituximab
• belimumab

Topics

• Animals
• Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (immunology, therapy)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antibodies, Monoclonal, Murine-Derived (therapeutic use)
• B-Cell Activating Factor (immunology)
• B-Lymphocytes (immunology)
• Clinical Trials as Topic
• Evidence-Based Medicine
• Humans
• Immunotherapy (methods, trends)
• Lupus Erythematosus, Systemic (immunology, therapy)
• Lymphocyte Depletion
• Molecular Targeted Therapy
• Rituximab
• Treatment Outcome