Rituximab, B-lymphocyte depletion, and preservation of beta-cell function.

The New England Journal of Medicine
Mark D PescovitzType 1 Diabetes TrialNet Anti-CD20 Study Group

Abstract

The immunopathogenesis of type 1 diabetes mellitus is associated with T-lymphocyte autoimmunity. However, there is growing evidence that B lymphocytes play a role in many T-lymphocyte-mediated diseases. It is possible to achieve selective depletion of B lymphocytes with rituximab, an anti-CD20 monoclonal antibody. This phase 2 study evaluated the role of B-lymphocyte depletion in patients with type 1 diabetes. We conducted a randomized, double-blind study in which 87 patients between 8 and 40 years of age who had newly diagnosed type 1 diabetes were assigned to receive infusions of rituximab or placebo on days 1, 8, 15, and 22 of the study. The primary outcome, assessed 1 year after the first infusion, was the geometric mean area under the curve (AUC) for the serum C-peptide level during the first 2 hours of a mixed-meal tolerance test. Secondary outcomes included safety and changes in the glycated hemoglobin level and insulin dose. At 1 year, the mean AUC for the level of C peptide was significantly higher in the rituximab group than in the placebo group. The rituximab group also had significantly lower levels of glycated hemoglobin and required less insulin. Between 3 months and 12 months, the rate of decline in C-peptide lev...Continue Reading

References

Dec 1, 1971·The Journal of Clinical Investigation·H D OchsR J Wedgwood
Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Feb 1, 1993·Diabetes Research and Clinical Practice·M T YilmazF Sipahioğlu
Dec 1, 1995·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·G Schernthaner
Aug 12, 1999·Annals of Oncology : Official Journal of the European Society for Medical Oncology·L D PiroV Jain
Aug 4, 2001·The New England Journal of Medicine·A Davidson, B Diamond
Oct 6, 2001·The New England Journal of Medicine·S MartinB O Roep
Oct 10, 2001·The Journal of Immunology : Official Journal of the American Association of Immunologists·S TakemuraC M Weyand
May 31, 2002·The New England Journal of Medicine·Kevan C HeroldJeffrey A Bluestone
Nov 1, 2002·Current Directions in Autoimmunity·David V Serreze, Pablo A Silveira
Aug 9, 2003·Arthritis and Rheumatism·Geraldine CambridgeAnthony D B Webster
Mar 11, 2004·Pediatric Transplantation·Mark D Pescovitz
Jul 23, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Avinash AgarwalMark D Pescovitz
Jan 8, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Christopher M BeardenMark D Pescovitz
Jun 24, 2005·The New England Journal of Medicine·Bart KeymeulenLucienne Chatenoud
Apr 14, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M D Pescovitz
Oct 19, 2007·Kidney International·F C FervenzaD C Cattran
Feb 15, 2008·The New England Journal of Medicine·Stephen L HauserUNKNOWN HERMES Trial Group
Oct 10, 2008·The New England Journal of Medicine·Johnny LudvigssonRosaura Casas

❮ Previous
Next ❯

Citations

Feb 14, 2018·The Journal of Clinical Investigation·David A OstrovAaron W Michels
Apr 13, 2018·The Journal of Immunology : Official Journal of the American Association of Immunologists·Kuan Y WongDavid J Munster
Oct 19, 2017·Current Diabetes Reports·Carla GreenbaumDana VanBuecken
Nov 17, 2010·Nature Immunology·Masaki Hikada, Moncef Zouali
Oct 22, 2017·The Journal of Immunology : Official Journal of the American Association of Immunologists·Qiming WangDavid V Serreze
May 4, 2017·The Journal of Immunology : Official Journal of the American Association of Immunologists·Jeremy J RatiuDavid V Serreze
Oct 25, 2017·The Journal of Immunology : Official Journal of the American Association of Immunologists·Jane H Buckner, Carla J Greenbaum
Feb 18, 2011·The Cochrane Database of Systematic Reviews·Jasvinder A SinghRachelle Buchbinder
Jun 4, 2013·The Cochrane Database of Systematic Reviews·Neda Minakaran, Daniel G Ezra
Jan 29, 2014·Nature Reviews. Endocrinology·Bart O Roep, Timothy I M Tree
Jun 26, 2018·Diabetes·Angeliki M StamatouliKevan C Herold
Jun 29, 2018·The Journal of Immunology : Official Journal of the American Association of Immunologists·Jamie L FeltonJames W Thomas
Dec 17, 2014·IUBMB Life·Noel G MorganSarah J Richardson
Jul 18, 2018·Diabetes Care·Michael J HallerUNKNOWN Type 1 Diabetes TrialNet ATG-GCSF Study Group
Oct 16, 2012·European Journal of Endocrinology·Sloboda CulinaRoberto Mallone
Sep 14, 2018·Brain : a Journal of Neurology·David BakerKlaus Schmierer
Nov 20, 2018·Expert Review of Vaccines·Heikki HyötyMikael Knip
Oct 12, 2010·Diabetes/metabolism Research and Reviews·Simona CerneaItamar Raz
Jun 28, 2011·Endocrine Reviews·Vedran BrezarRoberto Mallone
Apr 27, 2019·Annals of the New York Academy of Sciences·Tijana Martinov, Brian T Fife
Apr 10, 2019·JCI Insight·Christopher S WilsonDaniel J Moore
Mar 22, 2019·Diabetes·Tania HabibUNKNOWN Type 1 Diabetes TrialNet Study Group
May 1, 2010·Nature·Jeffrey A BluestoneGeorge Eisenbarth
Oct 19, 2017·Nature Reviews. Nephrology·Mia J SmithJohn C Cambier
Mar 31, 2010·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Sara MadaschiRoberto Lanzi
Oct 29, 2010·Expert Review of Clinical Immunology·Rodolfo José Chaparro, Teresa P Dilorenzo
May 28, 2019·The Journal of Immunology : Official Journal of the American Association of Immunologists·Blair T StocksDaniel J Moore
Feb 21, 2013·Current Opinion in Endocrinology, Diabetes, and Obesity·Oskar SkogOlle Korsgren
Jul 5, 2012·Current Opinion in Endocrinology, Diabetes, and Obesity·Nick Giannoukakis, Massimo Trucco
Jan 22, 2014·Current Opinion in Rheumatology·Robert A BensonAndrew M Platt
May 17, 2019·The Journal of Clinical Endocrinology and Metabolism·Xinyu XuTao Yang
Aug 1, 2015·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Mario R Ehlers
Mar 21, 2017·American Journal of Physiology. Heart and Circulatory Physiology·Prasad Srikakulapu, Coleen A McNamara
Jun 3, 2016·Current Opinion in Endocrinology, Diabetes, and Obesity·Farooq Syed, Carmella Evans-Molina

❮ Previous
Next ❯

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