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Usefulness of monitoring of B cell depletion in rituximab-treated rheumatoid arthritis patients in order to predict clinical relapse: a prospective observational study

Abstract : Our objective was to evaluate the contribution of monitoring B cell subset depletion after rituximab in patients with rheumatoid arthritis (RA) in order to guide reintroduction to forestall relapse. This prospective, monocentre study included all RA patients receiving two 1-g rituximab infusions at a 15-day interval. The patients were followed clinically and biologically every 2 months until rituximab reintroduction. The physician was blinded to lymphocyte-typing results to diagnose relapse and, hence, retreatment. Among the 39 patients included between March 2010 and December 2011 and followed until April 2013, seven received two rituximab cycles, yielding a total of 46 cycles for analysis. After the two rituximab cycles, the total number of CD19+ B cells decreased significantly (0·155 versus 0·0002 G/l, P < 0·0001), with complete depletions in all patients of CD19+ CD38++CD24++ (transitional) (P < 0·0001) and CD19+ CD27+ (memory) B lymphocytes. A significant majority of patients relapsed within the 4 months following repopulation of total B (P = 0·036), B transitional (P = 0·007) and B memory (P = 0·01) lymphocytes. CD19+ B lymphocyte repopulation preceded clinical RA relapse and enabled its prediction 4 months in advance. Hence, monitoring of CD19+ B lymphocytes could serve as a tool to predict those relapses
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https://hal-normandie-univ.archives-ouvertes.fr/hal-02372200
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Submitted on : Wednesday, November 20, 2019 - 11:55:59 AM
Last modification on : Tuesday, April 19, 2022 - 10:16:16 AM

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A.-P. Trouvin, S. Jacquot, S. Grigioni, E. Curis, I. Dedreux, et al.. Usefulness of monitoring of B cell depletion in rituximab-treated rheumatoid arthritis patients in order to predict clinical relapse: a prospective observational study. Clinical and Experimental Immunology, Wiley, 2015, 180 (1), pp.11-18. ⟨10.1111/cei.12481⟩. ⟨hal-02372200⟩

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