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THU0284 Dynamics of B Lymphocyte Subsets in SLE Patients Treated with Rituximab
  1. A.A. Mesnyankina,
  2. E.N. Aleksandrova,
  3. S.K. Soloviev,
  4. A.P. Aleksankin,
  5. S.I. Glukhova,
  6. A.A. Novikov,
  7. E.V. Suponitskaya,
  8. E.A. Aseeva,
  9. E.L. Nasonov
  1. V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation


Objectives to study B-cell subsets dynamics in SLE patients receiving rituximab (RTX) therapy with following 6 months observation.

Methods The study included 16 SLE pts (1m/15f) with high (SLEDAI2K>10 - 13 pts.) and moderate (SLEDAI2K<10- 3 pts.) disease activity. Out of them 7 pts with lupus nephritis and 3 pts with neurolupus. RTX was administered to pts who failed to respond to glucocorticoids (GCs) and cytostatics (CTs). B-cells subsets were assessed before RTX administration (month 0), and at month 3 and month 6 of RTX therapy. RTX was administered at 500 to 2000 mg doses depending on disease activity. We investigated the absolute and relative number of CD19+ B cells, the total population of memory B cells (CD19+CD27+), “preswitch” (CD19+IgD+CD27+) and “postswitch” (CD19+IgD-CD27+) memory B cells, naive (CD19+IgD+CD27-) and transitional (CD19+IgD+CD10+CD38++CD27-) B cells, plasmablasts (CD19+CD38+++IgD-CD27+CD20-), short-lived plasma cells (CD19+CD38+), long-lived plasma cells (CD19+CD138+), and double-negative B-cells (CD19+CD27-IgD) were measured. All B cell subsets were analyzed by technique of multicolor flow cytofluorometry using panel of monoclonal antibodies to surface membrane markers of B-lymphocytes.

Results Following initiation of RTX SLE clinical and lab activity indices have decreased in all 16 pts by month 3 and month 6 of follow up (SLEDAI-2K 0 month –Me 15 [11;19], 3 month -Me 7 [3;10], 6 month –Me 5 [4;9], p<0.05), as well as decrease of absolute count CD19 B-cell subpopulation (0 month – Me 0,11 [0,0741; 0,2], 3 month - Me 0,0017 [0; 0,003], 6 month - Me 0,0045 [0,0005; 0,01], p<0.05). B-cell repopulation by 6 month in 11 out of 16 pts was due to “naive” B-cells Me 0,00085 [0; 0,008], double negative Me 0,001 [0; 0,0025] and “postswitch” memory B-cells Me 0,0013 [0,0001; 0,003]. SLE exacerbation by 6 month was documented in 5 pts, in 3 out of them B-cell repopulation occurred. A correlation between baseline high SLE activity before RTX infusions (SLEDAI-2K 5 pts – Me 20 [18;24], 11 pts. Me 12 [8;12]) and SLE exacerbation at 6 month after initiation of RTM therapy (p<0,05, r=0,54) was found.

Conclusions Decrease in clinical and lab SLE activity was documented in all 16 pts by 3 month after one course of RTM therapy. In 3 out of 5 exacerbated pts at 6 month B-cell repopulation was found, but without significant correlation with counts of B-cells subpopulations during the whole follow up period.

Disclosure of Interest None declared

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