Treatment of rheumatoid arthritis with anti CD4 monoclonal antibody. Open study of 25 patients with the B-F5 clone

Clinical Rheumatology - Tập 11 Số 4 - Trang 542-547 - 1992
Wendling, D.1, Racadot, E.2, Morel-Fourrier, B.3, Wijdenes, J.3
1Service de Rhumatologie, Hôpital J. Minjoz, CHRU, Besançon, France
2Laboratoire d'Immunocytologie, Centre Régional de Transfusion Sanguine, Besançon, France
3Laboratoire des Anticorps Monoclonaux, Centre Régional de Transfusion Sanguine, Besançon, France

Tóm tắt

Twenty-five defined severe RA patients (pts) (17 F, 8 M) were treated in an open study with a CD4 murine monoclonal antibody (Mab) (B-F5 clone, IgG1). Mab's daily dose was 10 mg (1 pt), 15 mg (2 pts), 20 mg (17 pts), 30 mg (4 pts) and 50 mg (1 pt) for 10 days. Tolerance was fair. Clinical improvement occurred during treatment period or within the first month in all but 2 patients, irrespective of Mab dosage. Improvement duration was variable (1 to 12 months), half of the patients still show signs of improvement at month 4. Biological parameters (CRP) improved parallel to the clinical. At day 180, 25% of the patients showed a reduction of 50% or more of the initial CRP values. There is no modification of RF titers, renal and hepatic parameters. Sequential evaluation showed a decrease of B, TCD3, CD4, CD8 lymphocytes and monocytes two hours after Mab infusion and return to baseline in 20 hours. Xenogenic immunization occurred in 6 patients without influence upon clinical response. These modifications are moderate and transient and do not account for the more prolonged effect in some cases, nor do they offer any prediction of further clinical response.

Tài liệu tham khảo

citation_journal_title=Br J Rheumatol; citation_title=Immunogenetic and cellular immune mechanisms in rheumatoid arthritis: relevance to new therapeutic strategies; citation_author=G. Kingsley, C. Pitzalis, G.S. Panayi; citation_volume=29; citation_publication_date=1990; citation_pages=58-64; citation_doi=10.1093/rheumatology/29.1.58; citation_id=CR1 citation_journal_title=J Clin Invest; citation_title=Inhibition of human helper T cell function in vitro by D-penicillamine and CuS04; citation_author=P.E. Lipsky, M. Ziff; citation_volume=65; citation_publication_date=1980; citation_pages=1069-1069; citation_doi=10.1172/JCI109759; citation_id=CR2 citation_journal_title=Ann Rheum Dis; citation_title=Cyclosporin in rheumatoid arthritis: a double-blind placebo controlled study in 52 patients; citation_author=M. Dougados, H. Awada, B. Amor; citation_volume=47; citation_publication_date=1988; citation_pages=127-133; citation_doi=10.1136/ard.47.2.127; citation_id=CR3 citation_journal_title=Arthritis Rheum; citation_title=Lymphocyte involvement in rheumatoid arthritis. Studies during thoracic duct drainage; citation_author=H.E. Paulus, H.I. Machleder, S. Levine, D.T.Y. Yu, N.S. MacDonald; citation_volume=20; citation_publication_date=1990; citation_pages=1249-1262; citation_doi=10.1002/art.1780200614; citation_id=CR4 citation_journal_title=Arthritis Rheum; citation_title=Lymphoid irradiation in intractable rheumatoid arthritis; citation_author=M. Soden, J. Hassan, D.L. Scott; citation_volume=32; citation_publication_date=1989; citation_pages=523-530; citation_doi=10.1002/anr.1780320503; citation_id=CR5 citation_journal_title=Clin Exp Rheumatol; citation_title=Immunological treatment of rheumatoid arthritis; citation_author=J. Sany; citation_volume=8; citation_issue=suppl. 5; citation_publication_date=1990; citation_pages=81-88; citation_id=CR6 citation_journal_title=Eur J Rheumatol Inflam; citation_title=Immunomodulation by monoclonal antibodies directed against cell adhesion molecules: a special case for CD4 monoclonal antibodies; citation_author=G. Riethmuller, C. Reiter, B. Kakavand, M. Schattenkirchner, K. Kruger, J. Eisenburg, E.P. Rieber; citation_volume=11; citation_publication_date=1991; citation_pages=177-181; citation_id=CR7 citation_journal_title=Br J Rheumatol; citation_title=Monoclonal antibody treatment of rheumatoid arthritis; citation_author=G. Kingsley; citation_volume=30; citation_issue=suppl. 2; citation_publication_date=1991; citation_pages=33-35; citation_id=CR8 citation_journal_title=Arthritis Rheum; citation_title=Treatment of rheumatoid arthritis with an anti CD4 monoclonal antibody; citation_author=G. Horneff, G.R. Burmester, F. Emmrich, J.R. Kalden; citation_volume=34; citation_publication_date=1991; citation_pages=129-140; citation_doi=10.1002/art.1780340202; citation_id=CR9 citation_journal_title=J Autoimmunity; citation_title=Anti CD4 antibody treatment of patients with rheumatoid arthritis: I. Effect on clinical course and circulating T cells; citation_author=C. Herzog, C. Walker, W. Muller, P. Rieber, C. Reiter, G. Riethmuller, P. Wassmer, H. Stockinger, O. Madic, W.J. Pichler; citation_volume=2; citation_publication_date=1989; citation_pages=627-642; citation_doi=10.1016/S0896-8411(89)80002-2; citation_id=CR10 citation_journal_title=Arthritis Rheum; citation_title=Treatment of rheumatoid arthritis with monoclonal CD4 antibody M-T151; citation_author=C. Reiter, B. Kawavand, E.P. Rieber, M. Schattenkirchner, G. Riethmuller, K. Kruger; citation_volume=34; citation_publication_date=1991; citation_pages=525-536; citation_doi=10.1002/art.1780340504; citation_id=CR11 citation_journal_title=Arthritis Rheum; citation_title=Preliminary trial for an anti CD4 monoclonal antibody in rheumatoid arthritis; citation_author=D. Goldberg, L. Chatenoud, P. Morel, C. Boitard, J.P. Revillard, P. Bertoye, J.F. Bach, C.J. Menkes; citation_volume=33; citation_publication_date=1990; citation_pages=153-153; citation_doi=10.1002/art.1780330202; citation_id=CR12 citation_journal_title=J Rheumatol; citation_title=Therapeutic use of monoclonal anti CD4 antibody in rheumatoid arthritis; citation_author=D. Wendling, J. Wijdenes, E. Racadot, B. Morel-Fourrier; citation_volume=18; citation_publication_date=1991; citation_pages=325-327; citation_id=CR13 citation_journal_title=Arthritis Rheum; citation_title=The American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis; citation_author=F.C. Arnett, S.M. Edworthy, D.A. Bloch, D.J. McShane, J.F. Fries, N.S. Cooper, L.A. Healey, S.R. Kaplan, M.H. Liang, H.S. Luthra, T.A. Medsger, D.M. Mitchell, D.H. Neustadt, R.S. Pinals, J.G. Schaller, J.T. Sharp, R.L. Wilder, G.G. Hunder; citation_volume=31; citation_publication_date=1988; citation_pages=315-324; citation_doi=10.1002/art.1780310302; citation_id=CR14 citation_journal_title=JAMA; citation_title=Therapeutic criteria in rheumatoid arthritis; citation_author=O. Steinbrocker, C.H. Taaeger, R.C. Batterman; citation_volume=140; citation_publication_date=1949; citation_pages=659-662; citation_doi=10.1001/jama.1949.02900430001001; citation_id=CR15 citation_journal_title=Q J Med; citation_title=Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis; citation_author=D.M. Ritchie, J.A. Boyle, J.M. McInnes, M.K. Jasani, T.G. Dalakos, P. Grieveson, W.W. Buchanan; citation_volume=147; citation_publication_date=1968; citation_pages=393-406; citation_id=CR16 citation_journal_title=Clin Exp Rheumatol; citation_title=Immunological followup of 17 patients with rheumatoid arthritis treated in vivo with an anti T CD4 + monoclonal antibody (B-F5); citation_author=E. Racadot, J. Wijdenes, D. Wendling; citation_volume=10; citation_publication_date=1992; citation_pages=365-374; citation_id=CR17 citation_journal_title=Arthritis Rheum; citation_title=Preliminary criteria for clinical remission in rheumatoid arthritis; citation_author=R.S. Pinals, A.T. Masi, R.A. Larsen; citation_volume=24; citation_publication_date=1981; citation_pages=1308-1315; citation_doi=10.1002/art.1780241012; citation_id=CR18 citation_journal_title=Arthritis Rheum; citation_title=Chimeric monoclonal CD4 antibody induces a long lasting CD4 cell depletion in rheumatoid arthritis patients; citation_author=C. Reiter, P.A. Lubbe, F.C. Breedveld, P. Daddona, K. Kruger, B. Kakavand, G. Riethmuller; citation_volume=34; citation_publication_date=1991; citation_pages=91-91; citation_doi=10.1002/art.1780340504; citation_id=CR19 citation_journal_title=Arthritis Rheum; citation_title=Treatment of rheumatoid arthritis with chimeric CD4 monoclonal antibody; citation_author=null Lubbe, C. Reiter, G. Riethmuller, M.E. Sanders, F.C. Breedveld; citation_volume=34; citation_publication_date=1991; citation_pages=89-89; citation_doi=10.1002/art.1780340114; citation_id=CR20