Efficacy and Safety of Obinutuzumab in Systemic Lupus Erythematosus Patients with Secondary Non-response to Rituximab
Rheumatology 2022;00:1–5 DOI.org/10.1093/rheumatology/keac150
Recent studies have shown that obinutuzumab, a type-2 CD20 antibody, can potentially overcome the immunogenicity problems associated with secondary non-response to rituximab (2NDNR), restoring depletion and clinical response.
Arnold, et al. evaluated efficacy and safety of obinutuzumab in SLE patients with 2NDNR. Despite the limited patient numbers (9), this study identified that obinutuzumab was generally well tolerated with mild infusion reactions. After 6 months, patients switching from rituximab to obinutuzumab following 2NDNR achieved a reduction in SLEDAI-2K and BILAG-2004 score, significant improvement in complement C3 and dsDNA titres, and improvement in C4 levels. Treatment was effective in steroid-sparing in renal and non-renal SLE patients who had failed to respond to conventional immunosuppressants due to 2NDNR.