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Curr Dir Autoimmun. 2005;8:175-92.

B lymphocyte depletion in rheumatoid arthritis: targeting of CD20.

Author information

1
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.

PMID:
15564721
DOI:
10.1159/000082103
[Indexed for MEDLINE]
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