Longer duration of B cell depletion is associated with better outcome
Longer duration of B cell depletion is associated with better outcome
复制标题
DOI：
10.1093/rheumatology/kev036
复制
发表时间：
2015-10-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, David
中科院分区：
文献类型：
--
作者：
Dias, Sofia Sapeta;Rodriguez-Garcia, Veronica;Isenberg, David
Objective.对98例SLE患者进行为期12年的B细胞清除（BCD）治疗，并对清除的持续时间进行临床和血清学随访。一项对2000年1月至2012年12月在伦敦大学学院医院风湿病中心接受BCD治疗的所有SLE患者的临床和血清学特征的回顾性审查。采用经典的BILAG评分评估治疗前、治疗后6个月和12个月的临床活性。患者之间以及同一患者在不同情况下的耗竭时间差异极大。根据耗竭持续时间将患者分为两组，并使用12个月的定义阈值。耗竭持续时间较长的组结局较好，6个月和12个月时BILAG评分降低。该组还与患者病程中任何时间出现的淋巴细胞减少症相关。无其他临床或血清学特征与BCD持续时间较长相关。诱导更长BCD持续时间的BCD周期与更好的结局相关。淋巴细胞减少症可能有助于预测更长的耗竭持续时间和更好的结局，尽管机制尚不清楚。
Objective. To report on the long-term follow-up, clinically and serologically, of 98 patients with SLE treated with B cell depletion (BCD) over a 12 year period, focusing on the duration of the depletion.Methods. A retrospective review of clinical and serological features of all SLE patients treated with BCD from January 2000 until December 2012 in the Centre for Rheumatology, University College London Hospital. Clinical activity was assessed by the classic BILAG score at baseline and 6 and 12 months after the treatment.Results. The period of depletion is extremely variable between patients and within the same patient on different occasions. The patients were divided into two groups according to the duration of depletion and a defined threshold of 12 months was utilized. The group with longer duration of depletion was associated with a better outcome, with a decrease in BILAG score at 6 and 12 months. This group was also associated with lymphopenia present at any time during the course of the patient's disease. No other clinical or serological feature was associated with longer duration of BCD.Conclusion. Cycles of BCD that induce longer duration of BCD are associated with better outcome. Lymphopenia may help to predict longer duration of the depletion and better outcome, although the mechanism is unclear.