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The value of rituximab treatment in primary Sjögren's syndrome

Authors :
Hendrika Bootsma
Gwenny M Verstappen
Arjan Vissink
Jolien F van Nimwegen
Frans G. M. Kroese
Personalized Healthcare Technology (PHT)
Translational Immunology Groningen (TRIGR)
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.

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