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B Cell Therapies, Approved and Emerging: a Review of Infectious Risk and Prevention During Use

  • Infections and Arthritis (K Winthrop, Section Editor)
  • Published:
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Abstract

The development of B cell-targeted biologics represents a major advance in the treatment of autoimmune rheumatic diseases. As with other immunosuppressive agents, risk of infection is a key clinical concern. This review summarises safety data from 15 years of experience of rituximab in autoimmune diseases with a particular focus on opportunistic infection and class-specific complications and infection risk. Rarely, cases of progressive multifocal leucoencephalopathy in rituximab-treated patients (5/100 000) have accumulated over time although no proven causal association has yet been shown. With repeat cycles of therapy, hypogammaglobulinaemia has been observed in a larger proportion of patients and is associated with increased risk of serious infections. The infection profile of the newer B cell-targeted agent, belimumab, in patients with active systemic lupus erythematosus is also discussed. Data from registries are needed to extend insights further and also to evaluate for any impact with the difference in mode of action of belimumab and infection risk in this population.

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Conflict of Interest

Dr Md Yusof is an NIHR Doctoral Research Fellow and has no conflict of interest.

Dr Vital is an Associate Professor and an NIHR Clinician Scientist. He has received honoraria and research grant support from Roche and GSK.

Dr Buch is an Associate Professor and Honorary Consultant Rheumatologist. She has received honoraria from Abbvie, Bristol Myers Squibb, Roche-Chugai and grant support from Pfizer Ltd and Roche.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK

    Md Yuzaiful Md Yusof, Edward M. Vital & Maya H. Buch

  2. NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, LS7 4SA, UK

    Md Yuzaiful Md Yusof & Edward M. Vital

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  1. Md Yuzaiful Md Yusof
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  2. Edward M. Vital
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Correspondence to Maya H. Buch.

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This article is part of the Topical Collection on Infections and Arthritis

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Md Yusof, M.Y., Vital, E.M. & Buch, M.H. B Cell Therapies, Approved and Emerging: a Review of Infectious Risk and Prevention During Use. Curr Rheumatol Rep 17, 65 (2015). https://doi.org/10.1007/s11926-015-0539-7

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