Skip to main content
NCBI home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1995 Oct;54(10):846–849. doi: 10.1136/ard.54.10.846

Treatment of refractory juvenile chronic arthritis by monoclonal CD4 antibodies: a pilot study in two children.

G Horneff 1, U Dirksen 1, H Schulze-Koops 1, F Emmrich 1, V Wahn 1
PMCID: PMC1010022  PMID: 7492226

Abstract

OBJECTIVE--To study the effect of anti-CD4 treatment in patients suffering from refractory systemic onset juvenile chronic arthritis (JCA). METHODS--Two children were treated with the mouse CD4 antibody MAX.16H5. The effects on numbers of circulating CD4 T cells, clinical symptoms and C reactive protein (CRP) level were studied and the appearance of human antimouse immunoglobulin antibodies investigated. RESULTS--In patient one, disappearance of fever and malaise and a reduction of arthritic activity were observed together with a reduction in CRP. When disease activity returned eight weeks later, a second successful course of treatment was administered. It was possible to reduce the corticosteroid dosage permanently. In the other child, a first treatment cycle did not alter disease activity. A marked reduction in clinical and laboratory disease activity markers was observed after the second course. Only transient and mild side effects were observed. One patient exhibited a short lasting febrile reaction with chills, the other an urticarial rash. In both patients, human antibodies to mouse immunoglobulin became detectable. The decrease in the number of CD4 T cells in the peripheral blood was only short lasting and numbers returned to normal values within one to eight weeks, even after the second course of antibody treatment and under concomitant immunosuppressive treatment. No sustained clinical remissions could be achieved. CONCLUSIONS--These preliminary observations support the evidence of positive effects of CD4 antibody treatment in refractory systemic onset JCA. Long term efficacy, however, remains to be established.

Full text

PDF
846

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cassidy J. T., Levinson J. E., Bass J. C., Baum J., Brewer E. J., Jr, Fink C. W., Hanson V., Jacobs J. C., Masi A. T., Schaller J. G. A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis. Arthritis Rheum. 1986 Feb;29(2):274–281. doi: 10.1002/art.1780290216. [DOI] [PubMed] [Google Scholar]
  2. Herzog C., Walker C., Pichler W., Aeschlimann A., Wassmer P., Stockinger H., Knapp W., Rieber P., Müller W. Monoclonal anti-CD4 in arthritis. Lancet. 1987 Dec 19;2(8573):1461–1462. doi: 10.1016/s0140-6736(87)91158-5. [DOI] [PubMed] [Google Scholar]
  3. Horneff G., Burmester G. R., Emmrich F., Kalden J. R. Treatment of rheumatoid arthritis with an anti-CD4 monoclonal antibody. Arthritis Rheum. 1991 Feb;34(2):129–140. doi: 10.1002/art.1780340202. [DOI] [PubMed] [Google Scholar]
  4. Horneff G., Krause A., Emmrich F., Kalden J. R., Burmester G. R. Elevated levels of circulating tumor necrosis factor-alpha, interferon-gamma, and interleukin-2 in systemic reactions induced by anti-CD4 therapy in patients with rheumatoid arthritis. Cytokine. 1991 May;3(3):266–267. doi: 10.1016/1043-4666(91)90026-a. [DOI] [PubMed] [Google Scholar]
  5. Horneff G., Sack U., Kalden J. R., Emmrich F., Burmester G. R. Reduction of monocyte-macrophage activation markers upon anti-CD4 treatment. Decreased levels of IL-1, IL-6, neopterin and soluble CD14 in patients with rheumatoid arthritis. Clin Exp Immunol. 1993 Feb;91(2):207–213. doi: 10.1111/j.1365-2249.1993.tb05884.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Horneff G., Winkler T., Kalden J. R., Emmrich F., Burmester G. R. Human anti-mouse antibody response induced by anti-CD4 monoclonal antibody therapy in patients with rheumatoid arthritis. Clin Immunol Immunopathol. 1991 Apr;59(1):89–103. doi: 10.1016/0090-1229(91)90084-n. [DOI] [PubMed] [Google Scholar]
  7. Janossy G., Panayi G., Duke O., Bofill M., Poulter L. W., Goldstein G. Rheumatoid arthritis: a disease of T-lymphocyte/macrophage immunoregulation. Lancet. 1981 Oct 17;2(8251):839–842. doi: 10.1016/s0140-6736(81)91107-7. [DOI] [PubMed] [Google Scholar]
  8. Moreland L. W., Bucy R. P., Tilden A., Pratt P. W., LoBuglio A. F., Khazaeli M., Everson M. P., Daddona P., Ghrayeb J., Kilgarriff C. Use of a chimeric monoclonal anti-CD4 antibody in patients with refractory rheumatoid arthritis. Arthritis Rheum. 1993 Mar;36(3):307–318. doi: 10.1002/art.1780360304. [DOI] [PubMed] [Google Scholar]
  9. Moreland L. W., Pratt P. W., Bucy R. P., Jackson B. S., Feldman J. W., Koopman W. J. Treatment of refractory rheumatoid arthritis with a chimeric anti-CD4 monoclonal antibody. Long-term followup of CD4+ T cell counts. Arthritis Rheum. 1994 Jun;37(6):834–838. doi: 10.1002/art.1780370610. [DOI] [PubMed] [Google Scholar]
  10. Reiter C., Kakavand B., Rieber E. P., Schattenkirchner M., Riethmüller G., Krüger K. Treatment of rheumatoid arthritis with monoclonal CD4 antibody M-T151. Clinical results and immunopharmacologic effects in an open study, including repeated administration. Arthritis Rheum. 1991 May;34(5):525–536. doi: 10.1002/art.1780340504. [DOI] [PubMed] [Google Scholar]
  11. Wendling D., Wijdenes J., Racadot E., Morel-Fourrier B. Therapeutic use of monoclonal anti-CD4 antibody in rheumatoid arthritis. J Rheumatol. 1991 Mar;18(3):325–327. [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES