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Study of anti-CD20 therapy effective B cell depletion
Date:6/2/2008

igrams. Blood samples from all participants were obtained at baseline, on day 15, and at a 3-month followup, and analyzed for B cell repopulation.

After receiving one cycle of rituximab, 12 of the 17 patients showed a good clinical response, with significant improvement in the Disease Activity Score in 28 joints (DAS28). At the time of B cell recovery, the IgD +, CD27+ memory B cell subset was significantly larger in the nonresponder group. Within the group of 12 responders, 6 patients experienced an early relapse of RA activity, between 24 and 40 weeks after rituximab treatment. The relapsers were characterized by a significantly higher proportion of overall CD27+ memory B cells before therapy. 11 patients were re-treated and again achieved a good clinical response. After the second cycle of rituximab, the pattern of B cell reconstitution was repeated. The number of B cells was still reduced at the time of second depletion but recovered to levels similar to those following the first cycle of therapy. This indicates an unimpaired capacity of B cell regeneration after repeated B cell depletion.

Based on statistical analysis, the researchers found a significant correlation between the size of the IgD +, CD27+ memory B cell subset during the early phase of B cell repletion and the response to anti-CD20 treatment. "Patients with lower numbers of IgD memory cells at the beginning of peripheral B cell repopulation had a much more favorable clinical response," notes Dr. Tony. "Therefore, the extent of memory B cell repletion seems to be a key factor influencing the pathophysiology of RA."

While revealing a potentially important target for rituximab therapy in RA, this study calls for further research into whether patients with a high level of particular memory B cells may benefit from early re-treatment or may even require higher doses of this anti-CD20 antibody.


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Contact: Sean Wagner
swagner@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

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