Rituximab, an investigational B-cell depletion therapy that target CD20 to treat people with multiple sclerosis (MS), has significant effects on the characteristics of B-cells that return after treatment is stopped, with cells being less mature yet more activated toward a pro-inflammatory state, a study showed.
Treatment also affected immune system T-cells and myeloid cells.
Whether these changes impact patients clinically is unknown, its researchers said, and these findings may assist in further developing B-cell treatment approaches.
The study, “B cells reappear less mature and more activated after their anti-CD20–mediated depletion in multiple sclerosis,” was published in the journal Proceedings of the National Academy of Sciences.
MS, an autoimmune disease, is caused by the immune system mistakenly attacking the protective myelin sheath that covers nerve fibers. B-cells are a type of immune cell that drives inflammation in MS and immune attacks against myelin.
Ocrevus (ocrelizumab, marketed by Genentech) is an antibody-based therapy approved to treat people with relapsing MS and primary progressive MS (PPMS), as is Kesimpta (ofatumumab), by Novartis, recently approved in the U.S. for relapsing MS. Known as B-cell depleting therapies, they work by targeting a protein on the B-cell surface called CD20, which leads to the death of B-cells.
Rituximab (also developed by Genentech) is a B-cell depleting therapy currently being used off-label in MS.
However, as B-cells play an essential role in modulating immune responses, the impact of these B-cell depleting therapies on other parts of the immune system has not been fully explored.
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