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Curr Opin Rheumatol. 2008 May;20(3):263-8. doi: 10.1097/BOR.0b013e3282f5e08d.

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

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  • 1Charite Center 14, Charite University Hospital Berlin, Berlin, Germany. thomas.doerner@charite.de

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.

PMID:
18388516
[PubMed - indexed for MEDLINE]
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