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El
tratamiento con rituximab diferencial elimina los anticuerpos contra la insulina
en los pacientes con diabetes de nueva aparición tipo 1A durante un año, según
un estudio publicado en línea el 10 de agosto en la
diabetes.
El tratamiento con rituximab diferencialmente suprime anticuerpos a la insulina (IAA) en todos los pacientes con diabetes de nueva aparición tipo 1A durante un año, según un estudio publicado en línea el 10 de agosto en la diabetes.
Liping Yu, MD, de la Universidad de Colorado en Denver en Aurora, y sus colegas analizaron el efecto específico de rituximab en múltiples autoanticuerpos en 87 pacientes con nuevo inicio de diabetes tipo 1A.
Los participantes (de 8 a 40 años) recibió cuatro infusiones semanales de rituximab o un placebo o bien cerca de la aparición de la diabetes.
Radioinmunoensayo se utilizó para medir IAA y anticuerpos GAD65 (GADAs), insulinoma proteína asociada a 2 (IA2As), y ZnT8 (ZnT8As). The mean levels of autoantibodies during a three-year follow-up was the prim
Los niveles medios de anticuerpos durante un período de tres años de seguimiento fue la principal medida de resultado.
Los investigadores descubrieron que, en comparación con placebo, reduce notablemente los niveles de rituximab IAA, pero tuvo un efecto mucho menor en GADAs, IA2As y ZnT8As.
IAA desaparecido en un 40 por ciento de la IAA-positivos los pacientes tratados con rituximab en comparación con ninguno de los pacientes tratados con placebo.
En los pacientes tratados con insulina, los pacientes tratados con rituximab en los 50 días del diagnóstico de diabetes mostraron una reducción marcada en la IAA de un año para todos los pacientes, y durante tres años en cuatro pacientes.
Independientemente del tratamiento con rituximab, los pacientes que mantuvieron niveles de péptido C durante el primer año de seguimiento tuvieron una menor IAA decir al inicio del estudio en ambos grupos.
"Un solo curso de rituximab diferencialmente suprime la IAA, claramente el bloqueo de IAA durante> 1 año en pacientes tratados con insulina. Para los pacientes que recibieron insulina durante> 2 semanas antes de la administración de rituximab, no podemos evaluar si rituximab no sólo bloquea la adquisición de anticuerpos contra la insulina inducida por la administración de insulina y / o anticuerpos preformados también suprime la insulina ", escriben los autores.
Rituximab Suppresses Autoantibodies to Insulin
Last Updated: August 18, 2011.
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Treatment with rituximab differentially suppresses
autoantibodies to insulin in all patients with new-onset type 1A diabetes for a
year, according to a study published online Aug. 10 in Diabetes.
THURSDAY, Aug. 18 (HealthDay News) -- Treatment with rituximab differentially suppresses autoantibodies to insulin (IAAs) in all patients with new-onset type 1A diabetes for a year, according to a study published online Aug. 10 in Diabetes.
Liping Yu, M.D., from the University of Colorado Denver in Aurora, and colleagues analyzed the specific effect of rituximab on multiple islet autoantibodies in 87 patients with new-onset type 1A diabetes. Participants (aged 8 to 40 years) received four weekly infusions of either rituximab or placebo close to the onset of diabetes. Radioimmunoassay was used to measure IAAs and antibodies to GAD65 (GADAs), insulinoma-associated protein 2 (IA2As), and ZnT8 (ZnT8As). The mean levels of autoantibodies during a three-year follow-up was the primary outcome measure.
The investigators found that, compared to placebo, rituximab markedly reduced IAA levels, but had a much smaller effect on GADAs, IA2As, and ZnT8As. IAAs disappeared in 40 percent of IAA-positive patients treated with rituximab versus none of the placebo-treated patients. In patients receiving insulin, those treated with rituximab within 50 days of diabetes diagnosis showed marked reductions in IAAs at one year for all patients, and for three years in four patients. Irrespective of rituximab treatment, patients who maintained C-peptide levels during the first year of follow-up had lower mean IAAs at study entry in both the groups.
"A single course of rituximab differentially suppresses IAAs, clearly blocking IAAs for >1 year in insulin-treated patients. For the patients receiving insulin for >2 weeks prior to rituximab administration, we cannot assess whether rituximab not only blocks the acquisition of insulin antibodies induced by insulin administration and/or also suppresses preformed insulin autoantibodies," the authors write.
http://www.doctorslounge.com/index.php/news/pb/22439
THURSDAY, Aug. 18 (HealthDay News) -- Treatment with rituximab differentially suppresses autoantibodies to insulin (IAAs) in all patients with new-onset type 1A diabetes for a year, according to a study published online Aug. 10 in Diabetes.
Liping Yu, M.D., from the University of Colorado Denver in Aurora, and colleagues analyzed the specific effect of rituximab on multiple islet autoantibodies in 87 patients with new-onset type 1A diabetes. Participants (aged 8 to 40 years) received four weekly infusions of either rituximab or placebo close to the onset of diabetes. Radioimmunoassay was used to measure IAAs and antibodies to GAD65 (GADAs), insulinoma-associated protein 2 (IA2As), and ZnT8 (ZnT8As). The mean levels of autoantibodies during a three-year follow-up was the primary outcome measure.
The investigators found that, compared to placebo, rituximab markedly reduced IAA levels, but had a much smaller effect on GADAs, IA2As, and ZnT8As. IAAs disappeared in 40 percent of IAA-positive patients treated with rituximab versus none of the placebo-treated patients. In patients receiving insulin, those treated with rituximab within 50 days of diabetes diagnosis showed marked reductions in IAAs at one year for all patients, and for three years in four patients. Irrespective of rituximab treatment, patients who maintained C-peptide levels during the first year of follow-up had lower mean IAAs at study entry in both the groups.
"A single course of rituximab differentially suppresses IAAs, clearly blocking IAAs for >1 year in insulin-treated patients. For the patients receiving insulin for >2 weeks prior to rituximab administration, we cannot assess whether rituximab not only blocks the acquisition of insulin antibodies induced by insulin administration and/or also suppresses preformed insulin autoantibodies," the authors write.
http://www.doctorslounge.com/index.php/news/pb/22439
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