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Living life without B cells: is repeated B-cell depletion a safe and effective long-term treatment plan for rheumatoid arthritis?
MedLine Citation:
PMID:  22792128     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The continued efficacy of B-cell depletion in rheumatoid arthritis (RA) depends on repeated cycles of anti-CD20 treatment to maintain low levels of B cells. It is surprising that this significant manipulation of the humoral immune system is remarkably safe with repeated treatment and that rates of adverse effects remain stable, and may even decline, over subsequent courses. Although responses to vaccines and probably to new antigens are diminished, adaptive immunity nevertheless functions adequately despite markedly restricted B-cell numbers. In the 10 years or so since the widespread use of B-cell depletion, there is little to suggest that a long-term paucity of B cells puts patients at risk for malignancy or opportunistic infections, nor that it leads to treatment-resistant RA or complications. While time will tell whether this major alteration of the immune system has other consequences, it is remarkable that drastic reduction of B-cell numbers over the long term is tolerated so well, and that it maintains efficacy in RA therapy.
Authors:
David R Chen; Philip L Cohen
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  International journal of clinical rheumatology     Volume:  7     ISSN:  1758-4280     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101503080     Medline TA:  Int J Clin Rheumtol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  159-166     Citation Subset:  -    
Affiliation:
Section of Rheumatology, Department of Medicine, Temple University School of Medicine, 3322 North Broad St., Room 205, Philadelphia, PA 19140, USA.
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