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The value of rituximab treatment in primary Sjögren's syndrome
- Source :
- Clinical Immunology, Clinical Immunology, 182, 62-71. ACADEMIC PRESS INC ELSEVIER SCIENCE
- Publication Year :
- 2017
- Publisher :
- ACADEMIC PRESS INC ELSEVIER SCIENCE, 2017.
-
Abstract
- The rationale for B cell depletion therapy with rituximab in primary Sjogren's syndrome relies upon the well-established role of B cell hyperactivity in immunopathogenesis. In line with this notion, several biomarkers of B cell activity are significantly affected by treatment, both in the target organs and periphery. In contrast to most biological outcomes, clinical outcomes are not consistent between studies. Although two large RCTs did not meet their primary endpoint, several beneficial clinical effects of treatment have been shown. As discussed in this review, differences in study design and patient characteristics could explain the variation in results. Interestingly, a newly developed composite endpoint of subjective and objective outcomes did show a significant effect of rituximab in one of the large RCTs. Response predictors need to be identified to define more targeted inclusion criteria and achieve precision medicine. The positive effects seen on biological and clinical parameters warrant future studies to investigate this promising treatment modality.
- Subjects :
- 0301 basic medicine
Oncology
medicine.medical_specialty
Efficacy
Immunology
SALIVARY-GLANDS
Lymphocyte Activation
DISEASE-ACTIVITY
THERAPY
Epithelium
Salivary Glands
law.invention
DRY EYE
03 medical and health sciences
DOUBLE-BLIND
0302 clinical medicine
B-Cell Depletion Therapy
Randomized controlled trial
law
Internal medicine
B-CELL DEPLETION
Clinical endpoint
Immunology and Allergy
Medicine
Humans
SYSTEMIC-LUPUS-ERYTHEMATOSUS
B cell
030203 arthritis & rheumatology
B-Lymphocytes
business.industry
RANDOMIZED CONTROLLED-TRIAL
medicine.disease
Precision medicine
3. Good health
RHEUMATOID-ARTHRITIS
030104 developmental biology
medicine.anatomical_structure
Treatment Outcome
Sjogren's syndrome
Rheumatoid arthritis
Antirheumatic Agents
B cell depletion therapy
Rituximab
Sjogren s
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 15217035 and 15216616
- Volume :
- 182
- Database :
- OpenAIRE
- Journal :
- Clinical Immunology
- Accession number :
- edsair.doi.dedup.....5ea5f9683238635f9fa1c6e2b04e13ef
- Full Text :
- https://doi.org/10.1016/j.clim.2017.05.002