The development of antidrug antibodies to biologic therapies, notably drugs that consist of monoclonal antibodies (such as adalimumab and infliximab) has been reported in patients with rheumatoid arthritis. However, the clinical significance of these antidrug antibodies in the long-term follow up of RA patients is unknown.
Vaccinations are a critical component of RA clinical management, and their importance in preventing infection cannot be stressed enough. The majority of patients with RA are on immunosuppressive treatment, and a data driven approach to vaccinations in this high-risk population is essential.
Belimumab is a fully human IgG1λ antibody. It binds to the soluble cytokine, B-lymphocyte stimulator (BLyS) inhibiting its action. BLyS is important for the survival of B lymphocytes, but in patients with systemic lupus erythematosus (SLE) it is overexpressed.
Spleen tyrosine kinase (Syk) is an important mediator of inflammatory signals from extracellular receptors to the nucleus of immune cells. Inhibiting Syk with the oral, small-molecule inhibitor fostamatinib has shown efficacy compared to placebo in a short term study of RA patients on background methotrexate. Here, Weinblatt et al (NEJM 2010; published online ahead of […]
The dosage of rituximab commonly used in clinical practice (1000 mg infused twice, separated by two weeks) is largely empirically based. It is unclear whether lower doses will result in reduced efficacy or improved safety. Here, Emery et al (Ann Rheum Dis 2010; 69: 1629) explore patient outcomes in RA patients treated with 2 x […]