B Cell-Based Treatments in SLE: Past Experience and Current Directions

B cells have been targeted recently by novel therapeutic approaches in patients with SLE. In this review, we discuss recent data that have emerged on this issue placing special emphasis in studies published during the last 5 years.

Despite the negative results stemming from double-blind placebo-controlled studies, B cell depletion with rituximab is indeed employed worldwide, particularly in standard treatment refractory lupus, with promising results. In addition, positive experience with the approved agent belimumab is steadily increasing. Both regimens have an acceptable safety profile. Identification of B cells as a therapeutic target in SLE has been so far rewarding, since one such treatment, belimumab, has been the only regulatory authority-approved medication in SLE for over half a century. Focusing specifically on autoreactive instead of non-specifically altering/depleting lupus, B cells may lead to more rational treatment modes.