B-cell-targeted therapies in systemic lupus erythematosus and ANCA-associated vasculitis: current progress

Expert Rev Clin Immunol. 2013 Aug;9(8):761-72. doi: 10.1586/1744666X.2013.816479.


B cells play a central role in the pathogenesis of systemic lupus erythematosus and anti-neutrophil cytoplasmic antibody-associated vasculitis. There are various strategies for targeting B cells including depletion, inhibition of survival factors, activation and inhibition of co-stimulatory molecules. Controlled trials in systemic lupus erythematosus have shown positive results for belimumab, promising results for epratuzumab and negative results for rituximab. The failure of rituximab in controlled trials has been attributed to trial design, sample size and outcome measures rather than true inefficacy. In anti-neutrophil cytoplasmic antibody-associated vasculitis, rituximab is effective for remission induction and in relapsing disease. However, the optimal long-term re-treatment strategy remains to be determined. Over the next 5 years, evidence will be available regarding the clinical efficacy of these novel therapies, biomarkers and their long-term safety.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / immunology
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / therapy*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • B-Cell Activating Factor / immunology
  • B-Lymphocytes / immunology*
  • Clinical Trials as Topic
  • Evidence-Based Medicine
  • Humans
  • Immunotherapy / methods*
  • Immunotherapy / trends
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / therapy*
  • Lymphocyte Depletion
  • Molecular Targeted Therapy
  • Rituximab
  • Treatment Outcome


  • Antibodies, Monoclonal, Humanized
  • Antibodies, Monoclonal, Murine-Derived
  • B-Cell Activating Factor
  • epratuzumab
  • Rituximab
  • belimumab