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Serum levels of BAFF, but not APRIL, are increased after rituximab treatment in patients with primary Sjögren's syndrome: data from a placebo-controlled clinical trial
  1. Rodney P E Pollard1,
  2. Wayel H Abdulahad2,
  3. Arjan Vissink1,
  4. Nishath Hamza2,
  5. Johannes G M Burgerhof3,
  6. Jiska M Meijer1,
  7. Annie Visser2,
  8. Minke G Huitema2,
  9. Fred K L Spijkervet1,
  10. Cees G M Kallenberg2,
  11. Hendrika Bootsma2,
  12. Frans G M Kroese2
  1. 1Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  2. 2Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  3. 3Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Arjan Vissink, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO-Box 30.001, Groningen 9700 RB, The Netherlands; a.vissink{at}umcg.nl

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B cell depletion therapy with rituximab (RTX; 2 weekly infusions of 1000 mg, premedication: 100 mg prednisolone) in primary Sjögren's syndrome (pSS) patients is effective in reducing subjective and objective symptoms.1 As B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) are important cytokines involved in B cell survival and activation, we assessed in pSS patients included in a double-blind, randomised, placebo-controlled trial1 the effects of RTX on serum BAFF and APRIL levels up to 48 weeks after RTX.

Serum concentrations of BAFF and APRIL were measured by ELISA using kits from R&D systems (Minneapolis, Minnesota, USA) and Bender Med Systems (San Diego, California, USA), respectively. At baseline serum BAFF levels were significantly higher in pSS patients (n=28; median 1277 pg/ml (range 907–3802 pg/ml)) compared with healthy controls (n=10; median 983 pg/ml (range 600–1564 pg/ml)); p<0.01; figure 1A). Also, baseline serum APRIL levels were significantly higher in pSS patients (median 15 098 pg/ml (range 1891–228 591 pg/ml)) than in healthy controls (median 1965 pg/ml (range 889–4567 pg/ml); p<0.05; …

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