Drs. Sellam, Sibilia, and Mariette have received consulting fees, speaking fees, and/or honoraria from Roche (less than $10,000 each).
Blood memory B cells are disturbed and predict the response to rituximab in patients with rheumatoid arthritis†
Article first published online: 29 NOV 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 63, Issue 12, pages 3692–3701, December 2011
How to Cite
Sellam, J., Rouanet, S., Hendel-Chavez, H., Abbed, K., Sibilia, J., Tebib, J., Le Loët, X., Combe, B., Dougados, M., Mariette, X. and Taoufik, Y. (2011), Blood memory B cells are disturbed and predict the response to rituximab in patients with rheumatoid arthritis. Arthritis & Rheumatism, 63: 3692–3701. doi: 10.1002/art.30599
ClinicalTrials.gov identifier: NCT01126541.
- Issue published online: 29 NOV 2011
- Article first published online: 29 NOV 2011
- Accepted manuscript online: 30 AUG 2011 10:08AM EST
- Manuscript Accepted: 3 AUG 2011
- Manuscript Received: 19 JAN 2011
- Roche France
To examine blood B cell subsets in patients with rheumatoid arthritis (RA) prior to B cell depletion therapy and to assess their potential as predictors of clinical response to rituximab (RTX).
Blood B cell subsets were assessed by flow cytometry in 208 RA patients included in an RTX retreatment study (assessed prior to RTX treatment) and in 47 age-matched controls. Expression of BAFF receptor (BAFF-R) on B cells and serum B cell biomarkers was also measured. B cell subsets and BAFF-R expression were compared between RA patient and control populations. Univariate and multivariate analyses were performed to identify baseline factors associated with a European League Against Rheumatism response 24 weeks after 1 cycle of RTX.
Mean ± SD counts of both CD27− naive and CD27+ memory B cells were decreased in RA patients (188.6 ± 121.4/mm3) compared with controls (257.3 ± 154.1/mm3) (P = 0.001) and were partially restored in patients treated with methotrexate (MTX) plus anti–tumor necrosis factor compared with patients treated with MTX alone. Within the CD27+ memory B cells, the CD27+IgD− switched memory subtype was selectively decreased, irrespective of treatment. The frequency of CD27+ memory B cells correlated inversely with levels of several B cell activation biomarkers in RA. Serum BAFF level and BAFF-R expression was comparable in RA patients and controls. A low baseline CD27+ memory B cell frequency was associated with a greater clinical response to RTX (odds ratio 0.97 [95% confidence interval 0.95–0.99], P = 0.0015).
In B cell depletion therapy–naive RA patients, a low frequency of CD27+ memory B cells correlated with levels of serum B cell activation biomarkers and may predict response to RTX. These results suggest that low memory B cell frequency may be indicative of a B cell–driven RA subtype that is more sensitive to B cell depletion therapy.