Combined B cell/T cell therapy as novel approach for the re-induction of humoral immune-tolerance.

尽管在抗炎药物的开发方面做出了相当大的努力并取得了成功，但对于类风湿性关节炎（RA）还没有治愈性治疗。在提议的研究者发起的试验中，我们的目标是顺序地联合收割机结合B细胞靶向治疗和T细胞靶向治疗，以诱导临床缓解状态以及在自身抗体阳性的RA患者中重建免疫耐受。ACPA阳性的活动性RA患者将接受利妥昔单抗，随后接受阿巴西普或安慰剂治疗。主要结局是自身抗体（ACPA）水平的变化，而次要结局是ACPA糖基化和B细胞和T细胞应答的变化以及对临床疾病活动性的影响。

Despite considerable efforts and success in the development of anti-inflammatory drugs, there is yet no curative treatment for rheumatoid arthritis (RA). In the proposed investigator initiated trial we aim to sequentially combine a B cell-targeted therapy and a T cell-targeted therapy to induce a state of clinical remission as well as to re-establish immune tolerance in autoantibody-positive RA patients. ACPA-positive active RA patients will receive rituximab, followed by a treatment with abatacept or placebo. Primary outcome is the change in autoantibody (ACPA) levels, while secondary outcomes will be the change ACPA glycosylation and in B cell and T cell responses as well as the effects on clinical disease activity.