title: Treatment of primary Sjögren's syndrome with anti-CD20 therapy (rituximab). A feasible approach or just a starting point?
abstract: BACKGROUND
  In vitro and in vivo experimental data have suggested new immunopathogenic mechanisms in primary Sjögren's syndrome (pSS). The availability of targeted treatment modalities has opened new ways to selectively target these mechanistic pathways in vivo. Amongst these new treatment modalities, monoclonal antibodies specific for the B-cell surface molecule CD20 have been shown to be the most promising treatment option to date.
  
  
  METHODS
  A search of the Pubmed, MEDLINE, EMBASE, Cochrane and Ovid databases was performed to review literature on the efficacy and safety profile of anti-CD20 therapy in pSS patients.
  
  
  CONCLUSIONS
  A single course of the chimeric humanized anti-CD20 antibody rituximab was effective in reducing disease activity in pSS patients for about six to nine months. Retreatment of responders resulted in a similar effect to initial treatment. When combined with corticosteroids during infusion, rituximab was shown to be a safe drug to administer. Thus, anti-CD20 therapy can be considered an effective treatment option in pSS patients. However, large randomized controlled trials with anti-CD20 therapy, for example rituximab, are warranted in order to: 1) assess long-term effects of such treatment, 2) determine which pSS patients will benefit most from anti-CD20 treatment and 3) assess which retreatment schedule should be followed.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, The Netherlands.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Meiners
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
authors.forename: Cees G M
authors.initials: CG
authors.lastname: Kallenberg
authors.forename: Frans G M
authors.initials: FG
authors.lastname: Kroese
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
mesh_terms: D000818:Animals; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000276:immunology*; D005240:Feasibility Studies; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D000069283:Rituximab; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000069283:Rituximab