title: Optimising B-cell depletion in autoimmune disease: is obinutuzumab the answer?
abstract: In Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE), B-cell depletion therapy using rituximab results in variable clinical responses between individuals, which likely relates to variable B-cell depletion in the presence of immune defects. Outcomes in clinical trials with other type I anti-CD20 mAbs, ocrelizumab and ofatumumab, are comparable to rituximab. A mechanistically different type II mAb, obinutuzumab (OBZ), with greater capacity for B-cell depletion, has recently entered clinical trials in SLE. Here we consider whether type II anti-CD20 mAbs will provide mechanistic advantages to overcome the disease-related immune defects in autoimmune diseases such as SLE.
authors.affiliation: Centre for Rheumatology and Bloomsbury Rheumatology Unit, Division of Medicine, Rayne Building, 4th Floor, 5 University Street, WC1E 6JF, London, UK. Electronic address: v.reddy@ucl.ac.uk.
authors.forename: Venkat
authors.initials: V
authors.lastname: Reddy
authors.affiliation: Antibody and Vaccine Group, Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Lekh N
authors.initials: LN
authors.lastname: Dahal
authors.affiliation: Antibody and Vaccine Group, Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton, UK.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cragg
authors.affiliation: Centre for Rheumatology and Bloomsbury Rheumatology Unit, Division of Medicine, Rayne Building, 4th Floor, 5 University Street, WC1E 6JF, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Leandro
mesh_terms: D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology*; D004351:Drug Resistance; D006801:Humans; D000069283:Rituximab / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018951:Antigens, CD20; D000069283:Rituximab; C543332:obinutuzumab