B cell therapy for rheumatoid arthritis: The rituximab (anti-CD20) experience

Abstract

The clinical data to date strongly support the premise that B cells play a major part in the pathogenesis of RA and that selective targeting of these cells may provide treatments that not only enhance our understanding of this disease but also provide substantial and prolonged clinical benefit. Rituximab (Rituxan, MabThera) is an anti-CD20 chimeric monoclonal antibody that produces a high level of sustained efficacy in RA that coincides with a profound and longlasting peripheral depletion of CD20+ B cells after a single treatment course. Market experience from over 300 000 exposures to rituximab in patients with NHL demonstrates a well characterised safety profile. Early exposure data in RA suggest that the tolerability and safety profile of rituximab may be even better in these patients. Preliminary reports have also suggested that B cell targeting with rituximab is a promising approach for some other autoimmune conditions, particularly systemic lupus erythematosus. Further clinical trials with rituximab are underway to increase knowledge about, and further characterise the encouraging therapeutic profile of, this monoclonal antibody in RA and other autoimmune conditions.