Anti-CD20 monoclonal antibodies in Systemic Lupus Erythematosus. (January 2021)

• Record Type: Journal Article
• Authors: Shah, Kavina; Cragg, Mark; Leandro, Maria; Reddy, Venkat
• Is Part Of: Biologicals. Volume 69(2021)
• Page Start: 1
• Page End: 14
• Publication Date: 2021-01
• Subjects: Lupus -- Biologic -- B cell therapy -- Anti-CD20 monoclonal antibody -- Rituximab; Biological products -- Standards -- Periodicals; Biological Products -- Periodicals; Biological Products -- standards -- Periodicals; Produits biologiques -- Normes -- Périodiques; Biological products -- Standards; Periodicals; 615.37
• DOI: 10.1016/j.biologicals.2020.11.002
• Languages: English
• ISSNs: 1045-1056

Abstract

Abstract: Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory condition with a wide spectrum of disease manifestations and severities, resulting in significant morbidity and mortality. The aetiopathogenesis of SLE is complex. Young women and certain ethnicities are commonly affected, suggesting a significant hormonal and genetic influence. Diverse immunological abnormalities have been described. A characteristic abnormality is the presence of autoantibodies, implicating a central role for B cells in disease pathogenesis and/or perpetuation. Whilst conventional therapies have improved outcomes, a great unmet need remains. Recently, biological therapies are being explored. B-cell depletion therapy with rituximab has been in use off-label for nearly two decades. Inconsistent results between uncontrolled and controlled studies have raised doubts about its efficacy. In this review, we will focus on B cell abnormalities and the rationale behind B-cell depletion therapy with anti-CD20 monoclonal antibody (mAb), rituximab, will be explored including an evaluation of clinical and trial experience. Finally, we will discuss the mechanistic basis for considering alternative anti-CD20 mAbs.