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在接受长期治疗风湿性关节炎的Rituximab的患者中,是否应该保持完全的B细胞枯竭?

Roba Ghossan¹, Omar Al Tabaa¹, Alice Combier¹

¹Department of Rheumatology, Cochin Hospital AP-HP, Université Paris Cité, Paris, France.

Rheumatology (Oxford, England)

|October 4, 2023

概括

持久的B细胞枯竭与与风湿性关节炎患者治疗rituximab的更好的长期临床反应无关. 监测CD19水平在这个患者群体中提供了有限的益处.

科学领域:

免疫学免疫学免疫学
类风湿病学类风湿病学
临床药理学临床药理学

背景情况:

风湿性关节炎 (RA) 是一种慢性自身免疫性疾病.
利图西马布 (RTX) 是一种用于 RA 管理的 B 细胞消耗疗法.
长期RA治疗中持续的B细胞枯竭的临床意义尚未完全理解.

研究的目的:

调查接受RTX维持治疗的RA患者持续完全B细胞枯竭和长期临床反应之间的关联.
评估维持B细胞枯竭是否是一个可行的治疗目标,以优化RA治疗结果.

主要方法:

在2019-2021年期间接受RTX输注的RA患者的回顾性研究.
疾病活动评分28关节计数 (DAS28) -CRP在患有和没有持久性完全B细胞枯竭 (通过CD19计数定义) 患者之间的平均疾病活动评分28关节计数 (DAS28) -CRP的比较.
对二次终点的分析,包括DAS28,疼痛/疲劳VAS,CRP,马球蛋白和RA爆发频率.

主要成果:

在126名RA患者中,34%的患者表现出持续的完全B细胞枯竭.
在持久性B细胞枯竭或没有持久性B细胞枯竭的组之间没有观察到平均DAS28-CRP的显著差异.
调整后的分析和二次结果指标也显示,两组之间没有显著差异.

结论:

持续的完全B细胞枯竭与长期RTX治疗的RA患者的改善临床结果无关.
在RA患者中监测CD19水平的低疾病活性或RTX缓解具有有限的临床实用性.
目前针对RTX的RA的治疗策略可能不需要针对持续的B细胞枯竭.

关键词:

关节炎是一种关节炎.生物疗法是一种生物疗法.淋巴细胞枯竭淋巴细胞枯竭类风湿症患者的情况这就是Rituximab.

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