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Systemic Lupus Erythematosus


Reynolds JA, Toescu V, Yee CS et al.

City Hospital, Birmingham, UK.

 Lupus 2009;18:67–73.

Editor’s note: Systemic lupus erythematosus (SLE) is primarily a disease of B cell origin. Inhibiting or removing the autoreactive B cells is an attractive potential treatment strategy. Rituximab is a chimeric mouse–human monoclonal antibody directed against CD20 found on all human B cells with the exception of very early (B cell progenitor) and terminally differentiated (plasma) cells. CD20 is an ideal target as it is neither internalized nor soluble, and anti-CD20 immunoglobulin initiates B cell death. These authors present a retrospective review of 11 patients with refractory SLE treated with rituximab after failing to respond to corticosteroids and at least one other immunosuppressive drug. The authors measured clinical response using the British Isles Lupus Assessment Group (BILAG) index, serum complement, and reduction in maintenance prednisolone dose. B cells were measured using flow cytometry, and lung function testing was used to assess severe pulmonary disease (n=3).

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