B cell depletion with rituximab in the treatment of primary Sjögren's syndrome: what have we learnt?

Grigoriadou, Sofia and Chowdhury, Farzana and Pontarini, Elena and Tappuni, Anwar and Bowman, Simon J and Bombardieri, Michele B cell depletion with rituximab in the treatment of primary Sjögren's syndrome: what have we learnt? Clinical and experimental rheumatology, 37 Sup (3). pp. 217-224. ISSN 0392-856X.

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Abstract

Despite the well-established role of B cells in the pathogenesis of primary Sjögren's syndrome (pSS), the beneficial role of B-cell depletion therapy with rituximab remains elusive in this condition, contrary to other autoimmune diseases. Although early, small-scale studies showed promising results, two recent large randomised controlled trials did not meet their primary end-points. It is evident from most trials that rituximab has a positive impact on B-cell numbers and activity, both in the peripheral blood and in salivary glands, but clinical outcomes vary among studies. We review here the evidence to date of B-cell depletion in pSS, analysing the underlying causes for the discrepancies in different studies and their limitations. We also discuss the potential use of peripheral and salivary gland biomarkers for patient stratification and targeted patient selection. Overall, rituximab remains a plausible treatment for pSS provided future studies address the shortfalls that emerged from our current knowledge of the use of B-cell depletion in this condition.

Item Type: Article
Subjects: WD Diseases and disorders of systemic, metabolic or environmental origin > WD811 Rheumatology
Divisions: Ambulatory Care > Rheumatology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 30 Aug 2019 11:27
Last Modified: 30 Aug 2019 11:27
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2332

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