B-cell targeted treatments for lupus: The journey counts as much as the destination |
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| Authors: | Géraldine Falgarone Robin Dhote Marie-Christophe Boissier |
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| Affiliation: | 1. Rheumatology Department, Strasbourg University Hospital, Strasbourg, France;2. Epidemiology and Clinical Research, AP-HP, Pitié-Salpétrière Hospital, Paris, France;3. Internal Medicine Department, AP-HP, Cochin Hospital, Paris, France;4. Internal Medicine Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France;5. Rheumatology Department, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France;6. Internal Medicine and Clinical Immunology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France;7. Internal Medicine Department, AP-HP, Bichat Hospital, INSERM U1149, Paris, France;8. Rheumatology Department, AP-HP, Saint Antoine Hospital, INSERM UMRS_938, DHU i2B, Paris, France;9. Rheumatology Department, AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France;10. Internal Medicine Department, Strasbourg University Hospital, Strasbourg, France;11. Internal Medicine and Clinical Immunology Department, Dijon University Hospital, University of Bourgogne Franche-Comté, INSERM UMR 1098, FHU INCREASE, Dijon, France;12. Paediatric Immunology and Rheumatology Department, AP-HP, Necker Hospital, Institut Imagine, Paris, France;13. Internal Medicine Department, Colmar Hospital, Colmar, France;14. Nephrology Department, Strasbourg University Hospital, Strasbourg, France;15. Internal Medicine Department, Hôpital Européen, Marseille, France;p. Dermatology Department, AP-HP, Henri Mondor Hospital, Paris, France;q. Rheumatology Department, Montpellier University Hospital, Montpellier, France;r. Nephrology Department, AP-HP, Bichat Hospital, Paris, France;s. Medicine Department-DIMED, University of Padova, Padova, Italy;t. Internal Medicine Department, AP-HP, Saint Antoine Hospital, Paris, France;u. Nephrology Department, Nantes University Hospital, Nantes, France;v. Internal Medicine Department, AP-HP, Saint Louis Hospital, University of Paris Diderot, Paris, France;w. Rheumatology Department, Geneva University Hospital, Geneva, Switzerland;x. Internal Medicine Department, Lille University Hospital, University of Lille, Lille, France;y. Rheumatology Department, El Ayachi University Hospital, URAC 30, Faculty of Medicine, Salé, Morocco;z. Internal Medicine Department, Nantes University Hospital, Nantes, France;11. Pôle de maladies rhumatismales, Université Catholique de Louvain, Louvain-la-Neuve, Belgium;12. Nephrology Department, AP-HM, Marseille University Hospital, University Aix-Marseille, Marseille, France;13. Paediatric Rheumatology Department, AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France;14. Medicine Department, University of Algiers 1, Algiers, Algeria;15. Internal Medicine and Clinical Immunology Department, AP-HP, Bicêtre Hospital, Le Kremlin Bicêtre, France;16. Dermatology Department, Strasbourg University Hospital, Strasbourg, France;17. Internal Medicine Department, Caen University Hospital, Caen, France;18. Internal Medicine and Clinical Immunology Department, Strasbourg University Hospital, Strasbourg, France;19. Internal Medicine Department, Metz Hospital, Metz, France;110. Internal Medicine and Infectious Diseases Department, Versailles Hospital, Versailles, France;111. Rheumatology Department, AP-HP, Bichat Hospital, Paris, France;112. Internal Medicine Department, Nancy University Hospital, Nancy, France;113. Rheumatology Department, Tours University Hospital, University François Rabelais, CNRS 7292, Tours, France;114. Internal Medicine Department, Toulouse University Hospital, Toulouse, France;115. Internal Medicine Department, Amiens University Hospital, Amiens, France;1p. Dermatology Department, Clinique Mutualiste Catalane, Perpignan, France;1q. Internal Medicine Department, Ibn Sina Hospital, Rabat, Morocco;1r. Rheumatology Department, Tunis University Hospital, Tunis, Tunisia;1s. Vascular Medicine Department, Nancy University Hospital, INSERM U1116, Nancy, France;1t. INSERM UMR_S1109, Fédération de Médecine Translationnelle de Strasbourg (FMTS), FHU OMICARE, Strasbourg, France;1u. IBMC, CNRS, UPR3572, Strasbourg, France;1v. INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Le Kremlin Bicêtre, France;1w. CEA, DSV/iMETI, Division of Immuno-Virology, IDMIT, France;1x. Université Paris Sud, Le Kremlin Bicêtre, France;1y. Université de Strasbourg, Strasbourg, France;1z. Université Pierre et Marie Curie, Paris 6, France;21. Université de Lorraine, Nancy, France;22. University Mohammed V, Rabat, Morocco;23. Université René-Descartes Paris V, Paris, France;1. King''s College London, The Rayne Institute, 4th Floor Lambeth Wing, St Thomas'' Hospital, Westminster Bridge Road, SE1 7EH London, UK;2. Graham Hughes Lupus Research Laboratory, Division of Women''s Health, King''s College London, The Rayne Institute, Lambeth Wing, 4th Floor, St Thomas'' Hospital, London SE1 7EH, UK |
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| Abstract: | Obstacles facing therapeutic trials in systemic lupus erythematosus (SLE) include the low incidence, seriousness, complexity, and clinical polymorphism of the disease. A large-scale multicenter design has been required in most cases. Over the last few years, several biologics have been evaluated as treatments for lupus nephritis or for the skin and joint manifestations of SLE. The central role for the B-cell in SLE, together with improved knowledge of the targets on the B-cell surface, has prompted efforts to develop monoclonal antibodies as treatments for SLE. The two available monoclonal antibodies are rituximab (anti-CD20 antibody) and belimumab (anti-BlyS antibody). The results obtained with belimumab were used to develop a new measurement tool, the SLE Responder Index (SRI), and prompted an application for a license to use belimumab in SLE. Other targets identified on the B-cell surface are being evaluated. |
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