RESEARCH - B cell depletion therapy for patients with SLE results in a significant drop in anticardiolipin antibody titres

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Ann Rheum Dis. Published Online First: 28 September 2007.

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Concise Report

B cell depletion therapy for patients with systemic lupus erythematosus

results in a significant drop in anticardiolipin antibody titres

Yiannis Ioannou 1*, Anastasia Lambrianides 1, Geraldine Cambridge 1, J

Leandro 1, CW 1 and A Isenberg 1

1 University College London, United Kingdom

Abstract

B cell depletion therapy (BCDT) has recently been used with success to treat

patients with rheumatoid arthritis and SLE. As antiphospholipid antibodies

have been implicated in the pathogenesis of the antiphospholipid syndrome

(APS), we asked the question whether BCDT affects levels of IgG

anticardiolipin antibodies (aCL) in our cohort of 32 SLE patients given this

treatment. We identified seven SLE patients who had undergone BCDT and had

had at least two moderate positive aCL titres at least 12 weeks apart. Of

these only one patient had the APS. IgG aCL were measured at time 0 and 6-9

months post BCDT. At time 0, the mean IgG aCL level was 20.6 GPLU (range

10-32, SD 10.1, normal<5). At 6-9 months post depletion the IgG aCL levels

in six of the seven patients was undetectable and in the other patient the

level reduced from 25 GPLU to 15 GPLU (p<0.005, 2-tailed paired t-test). At

baseline, only one patient had a mildly positive anti-ß2GPI antibody level

at 30% (compared to an in-house standard), which fell to 5% post-BCDT. This

small observational study in patients with SLE is the first to demonstrate

that BCDT results in a significant reduction in levels of IgG aCL.

http://ard.bmj.com/cgi/content/abstract/ard.2007.078402v2

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