Treatment of severe cutaneous lupus erythematosus with a chimeric CD4 monoclonal antibody, cM-T412.
BACKGROUND
Monoclonal CD4 antibodies are among the most potent immunomodulatory agents in various experimental models of autoimmune disease, including murine lupus erythematosus.


OBJECTIVE
The aim of this study was to evaluate the toxicity and therapeutic efficacy of a chimeric monoclonal CD4 antibody, cM-T412, in patients with cutaneous lupus erythematosus (LE).


METHODS
Five patients with severe cutaneous LE lesions received intravenously a total of 275, 400, or 475 mg of cM-T412 in single doses of 20 to 50 mg during a period of 5 to 8 weeks.


RESULTS
CD4 antibody treatment induced a long-lasting decrease in disease activity. It resulted in healing of LE skin lesions, a reconstituted responsiveness to conventional treatment, or both. Despite a substantial depletion of circulating CD4+ T lymphocytes, no clinical signs of immunosuppression were noted.


CONCLUSIONS
Monoclonal CD4 antibodies should be considered as a novel treatment for the management of severe cutaneous LE.
Prinz
J C
JC
Department of Dermatology, Ludwig-Maximilians-University, Munich, FRG.
Meurer
M
M
Reiter
C
C
Rieber
E P
EP
Plewig
G
G
Riethmüller
G
G
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016860:CD4 Immunoadhesins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D004334:Drug Administration Schedule; D005148:Facial Dermatoses / Q000628:therapy; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007275:Injections, Intravenous; D008178:Lupus Erythematosus, Cutaneous / Q000473:pathology / Q000628:therapy*; D008179:Lupus Erythematosus, Discoid / Q000473:pathology / Q000628:therapy*; D008180:Lupus Erythematosus, Systemic / Q000473:pathology / Q000628:therapy; D008212:Lymphocyte Depletion; D008875:Middle Aged; D012074:Remission Induction; D012536:Scalp Dermatoses / Q000628:therapy; D001613:beta 2-Microglobulin / Q000032:analysis
D000276:Adjuvants, Immunologic; D000911:Antibodies, Monoclonal; D016860:CD4 Immunoadhesins; D001613:beta 2-Microglobulin