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Response to Rituximab may be sustained or transient -


Near Cognac, France
- Depending on the autoimmune disease and where the normal immune 'checkpoints' break down.

This is an interesting paper on the dynamics of the response to Ritux treatment of Type I diabetes (interesting in itself - I wasn't aware it was being trialled).

It appears that the therapeutic response in T1D is transient and likely to be so in other autoimmune diseases characterised by early 'central' (in the thymus and bone marrow) B cell tolerance impairment (e.g. T1D; RA; SLE). In contrast those with a specific defective peripheral B cell tolerance checkpoint (e.g. Multiple Sclerosis) may have a more sustained remission.

Rituximab does not reset defective early B cell tolerance checkpoints

We conclude that anti–B cell therapy may provide a temporary dampening of autoimmune processes through B cell depletion. However, repletion with autoreactive B cells may explain the relapse that occurs in many autoimmune patients after anti–B cell therapy.