Targeting CD38 with Daratumumab in Refractory Systemic Lupus Erythematosus

使用达雷木单抗靶向 CD38 治疗难治性系统性红斑狼疮

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作者:Lennard Ostendorf, Marie Burns, Pawel Durek, Gitta Anne Heinz, Frederik Heinrich, Panagiotis Garantziotis, Philipp Enghard, Ulrich Richter, Robert Biesen, Udo Schneider, Fabian Knebel, Gerd Burmester, Andreas Radbruch, Henrik E Mei, Mir-Farzin Mashreghi, Falk Hiepe, Tobias Alexander

Abstract

Daratumumab, a human monoclonal antibody that targets CD38, depletes plasma cells and is approved for the treatment of multiple myeloma. Long-lived plasma cells are implicated in the pathogenesis of systemic lupus erythematosus because they secrete autoantibodies, but they are unresponsive to standard immunosuppression. We describe the use of daratumumab that induced substantial clinical responses in two patients with life-threatening lupus, with the clinical responses sustained by maintenance therapy with belimumab, an antibody to B-cell activating factor. Significant depletion of long-lived plasma cells, reduction of interferon type I activity, and down-regulation of T-cell transcripts associated with chronic inflammation were documented. (Supported by the Deutsche Forschungsgemeinschaft and others.).

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