Update on the use of rituximab for intractable rheumatoid arthritis

R John LooneyUniversity of Rochester, Rochester, New York, USAAbstract: It has been 3 years since rituximab, a mouse x human chimeric anti-CD20 monoclonal antibody that selectively depleted B cells, was approved by the FDA for the treatment of moderate to severe rheumatoid arthritis (RA) with an ina...

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Autor principal:	R John Looney
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2009
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/967a4a12fae44754a99f5bcadd572bbe
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spelling	oai:doaj.org-article:967a4a12fae44754a99f5bcadd572bbe2021-12-02T07:48:31ZUpdate on the use of rituximab for intractable rheumatoid arthritis1179-156Xhttps://doaj.org/article/967a4a12fae44754a99f5bcadd572bbe2009-07-01T00:00:00Zhttp://www.dovepress.com/update-on-the-use-of-rituximab-for-intractable-rheumatoid-arthritis-a3320https://doaj.org/toc/1179-156XR John LooneyUniversity of Rochester, Rochester, New York, USAAbstract: It has been 3 years since rituximab, a mouse x human chimeric anti-CD20 monoclonal antibody that selectively depleted B cells, was approved by the FDA for the treatment of moderate to severe rheumatoid arthritis (RA) with an inadequate response to anti-TNF therapies. Since approval rituximab has become a part of standard treatment, and additional data have become available on long-term efficacy and safety both from clinical trials and from post-marketing surveillance. In open long-term follow-up from clinical trials, patients treated with multiple courses of rituximab continued to respond in terms of signs and symptoms, and damage assessed radiographically was significantly inhibited. Moreover, the rate of serious infectious events was not increased as the number of courses increased. However, because of case reports of progressive multifocal leukoencephalopathy in patients treated with rituximab for non-malignant conditions, a black box warning has been added. Studies on the immunologic correlates of response to rituximab treatment including B cell subsets in peripheral blood and synovial biopsies are providing clues into how rituximab works for autoimmune disease. However, at this time we are not able to explain why some patients do not respond and cannot predict who will respond. Future challenges for the further development of rituximab for intractable RA will be discussed.Keywords: rheumatoid arthritis, rituximab, B cells, immunocompetency R John LooneyDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2009, Iss default, Pp 83-94 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 R John Looney Update on the use of rituximab for intractable rheumatoid arthritis
description	R John LooneyUniversity of Rochester, Rochester, New York, USAAbstract: It has been 3 years since rituximab, a mouse x human chimeric anti-CD20 monoclonal antibody that selectively depleted B cells, was approved by the FDA for the treatment of moderate to severe rheumatoid arthritis (RA) with an inadequate response to anti-TNF therapies. Since approval rituximab has become a part of standard treatment, and additional data have become available on long-term efficacy and safety both from clinical trials and from post-marketing surveillance. In open long-term follow-up from clinical trials, patients treated with multiple courses of rituximab continued to respond in terms of signs and symptoms, and damage assessed radiographically was significantly inhibited. Moreover, the rate of serious infectious events was not increased as the number of courses increased. However, because of case reports of progressive multifocal leukoencephalopathy in patients treated with rituximab for non-malignant conditions, a black box warning has been added. Studies on the immunologic correlates of response to rituximab treatment including B cell subsets in peripheral blood and synovial biopsies are providing clues into how rituximab works for autoimmune disease. However, at this time we are not able to explain why some patients do not respond and cannot predict who will respond. Future challenges for the further development of rituximab for intractable RA will be discussed.Keywords: rheumatoid arthritis, rituximab, B cells, immunocompetency
format	article
author	R John Looney
author_facet	R John Looney
author_sort	R John Looney
title	Update on the use of rituximab for intractable rheumatoid arthritis
title_short	Update on the use of rituximab for intractable rheumatoid arthritis
title_full	Update on the use of rituximab for intractable rheumatoid arthritis
title_fullStr	Update on the use of rituximab for intractable rheumatoid arthritis
title_full_unstemmed	Update on the use of rituximab for intractable rheumatoid arthritis
title_sort	update on the use of rituximab for intractable rheumatoid arthritis
publisher	Dove Medical Press
publishDate	2009
url	https://doaj.org/article/967a4a12fae44754a99f5bcadd572bbe
work_keys_str_mv	AT rjohnlooney updateontheuseofrituximabforintractablerheumatoidarthritis
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Update on the use of rituximab for intractable rheumatoid arthritis

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