mAbs in nonlupus autoimmune rheumatic disease.
OBJECTIVE
mAb therapies are being used more frequently in all medical conditions, including the autoimmune rheumatic diseases. Autoimmune myositis, vasculitis and primary Sjogren's syndrome are rare diseases in which these therapies are being used without the support of large-scale randomized controlled trials. We have summarized the evidence that does exist to support the use of mAb therapies in these diseases.


RESULTS
There have been a number of open-label trials and case reports using mainly rituximab and antitumour necrosis factor-alpha agents to treat these diseases. The results have in general shown efficacy, the main exception being the use of antitumour necrosis factor-alpha agents with cyclophosphamide for the treatment of vasculitis.


CONCLUSIONS
mAb therapies have shown efficacy in the treatment of patients with autoimmune rheumatic diseases who have failed conventional therapy. Their use ahead of conventional immunosuppressive strategies cannot be supported on the basis of current evidence.
Whelan
Bryan R
BR
Department of Medicine, Centre for Rheumatology, University College London, London, UK. bryanwhelan@ireland.com
Isenberg
David A
DA
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D000069285:Infliximab; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000276:immunology; D000069283:Rituximab; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; C448700:epratuzumab; D000069283:Rituximab; D000069285:Infliximab