title: Anti-B cell antibody therapies for inflammatory rheumatic diseases.
abstract: Several monoclonal antibodies targeting B cells have been tested as therapeutics for inflammatory rheumatic diseases. We review important observations from randomized clinical trials regarding the efficacy and safety of anti-B cell antibody-based therapies for rheumatoid arthritis, systemic lupus erythematosus, antineutrophil cytoplasmic antibody-associated vasculitis, polymyositis/dermatomyositis, and primary Sjögren's syndrome. For some anti-B cell agents, clinical benefits have been convincingly demonstrated, while other B cell-targeted therapies failed to improve outcomes when added to standard-of-care treatment or were associated with increased rates of adverse events. Although the risk-benefit balance seems to be acceptable for currently licensed anti-B cell agents, additional studies are required to fully assess the safety of treatment regimens involving prolonged interference with B cell counts and functions in rheumatic disorders. Future studies should also evaluate how to maintain disease control by means of conventional and/or biologic immunosuppressants after remission-induction with anti-B cell antibodies.
authors.affiliation: Department of Infectious Diseases and Rheumatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen DK-2100, Denmark; email: mikkelf@dadlnet.dk.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Faurschou
authors.forename: David R W
authors.initials: DR
authors.lastname: Jayne
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000188:drug therapy; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001402:B-Lymphocytes / Q000276:immunology*; D003882:Dermatomyositis / Q000188:drug therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D000069283:Rituximab; D051918:Sialic Acid Binding Ig-like Lectin 2 / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000188:drug therapy
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D018501:Antirheumatic Agents; D011993:Recombinant Fusion Proteins; D051918:Sialic Acid Binding Ig-like Lectin 2; C448700:epratuzumab; D000069283:Rituximab; C511911:belimumab; C533411:ocrelizumab; C524618:TACI receptor-IgG Fc fragment fusion protein; C527517:ofatumumab