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Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases
B-cell targeted therapies (BCTT) are now widely used in autoimmune rheumatic diseases, including SLE, antineutrophil cytoplasmic antibody-associated vasculitis and rheumatoid arthritis. Early studies suggested that rituximab did not influence serum immunoglobulins. However, subsequently, with increa...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667775/ https://www.ncbi.nlm.nih.gov/pubmed/31413852 http://dx.doi.org/10.1136/lupus-2019-000337 |
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author | Wijetilleka, Sonali Jayne, David Mukhtyar, Chetan Karim, Mohammed Yousuf |
author_facet | Wijetilleka, Sonali Jayne, David Mukhtyar, Chetan Karim, Mohammed Yousuf |
author_sort | Wijetilleka, Sonali |
collection | PubMed |
description | B-cell targeted therapies (BCTT) are now widely used in autoimmune rheumatic diseases, including SLE, antineutrophil cytoplasmic antibody-associated vasculitis and rheumatoid arthritis. Early studies suggested that rituximab did not influence serum immunoglobulins. However, subsequently, with increased patient numbers, longer follow-up duration and many patients having received multiple BCTT courses, multiple subsequent studies have identified hypogammaglobulinaemia as a potential side effect. Patients developing hypogammaglobulinaemia appear to fit into two principal categories: the majority who develop transient, often mild reduction in immunoglobulins without increased infection and a much smaller but clinically significant group with a more sustained antibody deficiency, who display increased risk of infection. Monitoring immunoglobulin levels represents an opportunity for the early detection of hypogammaglobulinaemia, and the prevention of avoidable morbidity. In the two major studies, approximately 4%–5% of BCTT-treated patients required immunoglobulin replacement due to recurrent infections in the context of hypogammaglobulinaemia. Despite this, monitoring of immunoglobulins is suboptimal, and there remains a lack of awareness of hypogammaglobulinaemia as an important side effect. |
format | Online Article Text |
id | pubmed-6667775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-66677752019-08-14 Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases Wijetilleka, Sonali Jayne, David Mukhtyar, Chetan Karim, Mohammed Yousuf Lupus Sci Med Brief Communication B-cell targeted therapies (BCTT) are now widely used in autoimmune rheumatic diseases, including SLE, antineutrophil cytoplasmic antibody-associated vasculitis and rheumatoid arthritis. Early studies suggested that rituximab did not influence serum immunoglobulins. However, subsequently, with increased patient numbers, longer follow-up duration and many patients having received multiple BCTT courses, multiple subsequent studies have identified hypogammaglobulinaemia as a potential side effect. Patients developing hypogammaglobulinaemia appear to fit into two principal categories: the majority who develop transient, often mild reduction in immunoglobulins without increased infection and a much smaller but clinically significant group with a more sustained antibody deficiency, who display increased risk of infection. Monitoring immunoglobulin levels represents an opportunity for the early detection of hypogammaglobulinaemia, and the prevention of avoidable morbidity. In the two major studies, approximately 4%–5% of BCTT-treated patients required immunoglobulin replacement due to recurrent infections in the context of hypogammaglobulinaemia. Despite this, monitoring of immunoglobulins is suboptimal, and there remains a lack of awareness of hypogammaglobulinaemia as an important side effect. BMJ Publishing Group 2019-07-30 /pmc/articles/PMC6667775/ /pubmed/31413852 http://dx.doi.org/10.1136/lupus-2019-000337 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Brief Communication Wijetilleka, Sonali Jayne, David Mukhtyar, Chetan Karim, Mohammed Yousuf Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title | Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title_full | Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title_fullStr | Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title_full_unstemmed | Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title_short | Iatrogenic antibody deficiency from B-cell targeted therapies in autoimmune rheumatic diseases |
title_sort | iatrogenic antibody deficiency from b-cell targeted therapies in autoimmune rheumatic diseases |
topic | Brief Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667775/ https://www.ncbi.nlm.nih.gov/pubmed/31413852 http://dx.doi.org/10.1136/lupus-2019-000337 |
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