title: Longer duration of B cell depletion is associated with better outcome.
abstract: OBJECTIVE
  To report on the long-term follow-up, clinically and serologically, of 98 patients with SLE treated with B cell depletion (BCD) over a 12 year period, focusing on the duration of the depletion.
  
  
  METHODS
  A retrospective review of clinical and serological features of all SLE patients treated with BCD from January 2000 until December 2012 in the Centre for Rheumatology, University College London Hospital. Clinical activity was assessed by the classic BILAG score at baseline and 6 and 12 months after the treatment.
  
  
  RESULTS
  The period of depletion is extremely variable between patients and within the same patient on different occasions. The patients were divided into two groups according to the duration of depletion and a defined threshold of 12 months was utilized. The group with longer duration of depletion was associated with a better outcome, with a decrease in BILAG score at 6 and 12 months. This group was also associated with lymphopenia present at any time during the course of the patient's disease. No other clinical or serological feature was associated with longer duration of BCD.
  
  
  CONCLUSIONS
  Cycles of BCD that induce longer duration of BCD are associated with better outcome. Lymphopenia may help to predict longer duration of the depletion and better outcome, although the mechanism is unclear.
authors.affiliation: Internal Medicine Department 1, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: Sofia Sapeta
authors.initials: SS
authors.lastname: Dias
authors.affiliation: Rheumatology Department, Hospital Regional Universitario Carlos Haya, Malaga, Spain and.
authors.forename: Veronica
authors.initials: V
authors.lastname: Rodriguez-Garcia
authors.affiliation: Centre for Rheumatology, Department of Medicine, University College London, London, UK.
authors.forename: Hanh
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Centre for Rheumatology, Department of Medicine, University College London, London, UK.
authors.forename: Charis
authors.initials: C
authors.lastname: Pericleous
authors.affiliation: Centre for Rheumatology, Department of Medicine, University College London, London, UK d.isenberg@ucl.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Isenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects*; D001402:B-Lymphocytes / Q000187:drug effects / Q000473:pathology*; D002452:Cell Count; D003520:Cyclophosphamide / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008131:London; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000473:pathology; D008231:Lymphopenia / Q000453:epidemiology; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab / Q000494:pharmacology* / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D000069283:Rituximab; D003520:Cyclophosphamide; D008775:Methylprednisolone
keywords: B cells; SLE; dsDNA antibodies; outcome; remission