TY - JOUR
T1 - B-cell-depleting Therapy in Systemic Lupus Erythematosus
AU - Ramos-Casals, Manuel
AU - Sanz, Inaki
AU - Bosch, Xavier
AU - Stone, John H.
AU - Khamashta, Munther A.
PY - 2012/4
Y1 - 2012/4
N2 - The emergence of a new class of agents (B-cell-depleting therapies) has opened a new era in the therapeutic approach to systemic lupus erythematosus, with belimumab being the first drug licensed for use in systemic lupus erythematosus in more than 50 years. Four agents deserve specific mention: rituximab, ocrelizumab, epratuzumab, and belimumab. Controlled trials have shown negative results for rituximab, promising results for epratuzumab, and positive results for belimumab. Despite these negative results, rituximab is the most-used agent in patients who do not respond or are intolerant to standard therapy and those with life-threatening presentations. B-cell-depleting agents should not be used in patients with mild disease and should be tailored according to individual patient characteristics, including ethnicity, organ involvement, and the immunological profile. Forthcoming studies of B-cell-directed strategies, particularly data from investigations of off-label rituximab use and postmarketing studies of belimumab, will provide new insights into the utility of these treatments in the routine management of patients with systemic lupus erythematosus. (C) 2012 Elsevier Inc. All rights reserved. The American Journal of Medicine (2012) 125, 327-336
AB - The emergence of a new class of agents (B-cell-depleting therapies) has opened a new era in the therapeutic approach to systemic lupus erythematosus, with belimumab being the first drug licensed for use in systemic lupus erythematosus in more than 50 years. Four agents deserve specific mention: rituximab, ocrelizumab, epratuzumab, and belimumab. Controlled trials have shown negative results for rituximab, promising results for epratuzumab, and positive results for belimumab. Despite these negative results, rituximab is the most-used agent in patients who do not respond or are intolerant to standard therapy and those with life-threatening presentations. B-cell-depleting agents should not be used in patients with mild disease and should be tailored according to individual patient characteristics, including ethnicity, organ involvement, and the immunological profile. Forthcoming studies of B-cell-directed strategies, particularly data from investigations of off-label rituximab use and postmarketing studies of belimumab, will provide new insights into the utility of these treatments in the routine management of patients with systemic lupus erythematosus. (C) 2012 Elsevier Inc. All rights reserved. The American Journal of Medicine (2012) 125, 327-336
U2 - 10.1016/j.amjmed.2011.09.010
DO - 10.1016/j.amjmed.2011.09.010
M3 - Literature review
VL - 125
SP - 327
EP - 336
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -