Treatment of refractory rheumatoid arthritis with a monoclonal antibody to intercellular adhesion molecule 1.
OBJECTIVE
To assess the safety and efficacy of a monoclonal antibody (MAb) to intercellular adhesion molecule 1 (ICAM-1; CD54) in rheumatoid arthritis (RA).


METHODS
A phase I/II, open-label, dose-escalation study of 32 patients.


RESULTS
During treatment, a peripheral CD3+/CD4+ lymphocytosis was noted, and several patients demonstrated transient cutaneous anergy, which suggests that therapy modified T cell recirculation. Thirteen of the 23 patients who received 5 days of treatment demonstrated clinical improvement through day 29, and 9 of 23 through day 60. Adverse effects were minor and transient.


CONCLUSIONS
Anti-ICAM-1 MAb therapy was well tolerated, resulted in a transient alteration in T lymphocyte recirculation, and effected clinical improvement in some RA patients.
Kavanaugh
A F
AF
University of Texas Southwestern Medical Center, Dallas 75235-8884.
Davis
L S
LS
Nichols
L A
LA
Norris
S H
SH
Rothlein
R
R
Scharschmidt
L A
LA
Lipsky
P E
PE
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015703:Antigens, CD / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015815:Cell Adhesion Molecules / Q000276:immunology*; D002452:Cell Count; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis; D018799:Intercellular Adhesion Molecule-1; D016131:Lymphocyte Subsets; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D009504:Neutrophils; D010641:Phenotype
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D015815:Cell Adhesion Molecules; D018799:Intercellular Adhesion Molecule-1