Table 3 Some newer experimental treatments—a rapidly evolving list.
| Drug name | Construction | Target | Effect | Possible future indication | Reference |
|---|---|---|---|---|---|
| Rituximab (Mabthera) | Chimeric (murine/human) | CD20 | B depletion with minimal effect on immunoglobulins or ANCA | RA, ANCA associated vasculitis. Lupus (no large randomised trials yet) | Edwards46 |
| Epratuzumab | Humanised | CD22 (internalisation) | Non‐depleting | Sjögren's and lupus, ?in combination with depleting drugs? | Dorner47 |
| Alemtuzumab (Campath‐1H) | Humanised | CD52 (T and B cells) | Sustained T depletion | Behcet's | Lockwood48 |
| Abatacept (Orencia) (CTLA‐4Ig) | Recombinant fusion protein | B7(CD80,86): CD28 B, T costimulation | Rheumatoid arthritis, lupus | Genovese49 | |
| TACI‐Ig | Murine, experimental | BAFF blockade | Reduce B proliferation | Lupus, ?in combination | Ramanujam50 |
| Belimumab, lymphostat B | Human | Anti‐BAFF | Reduce B proliferation | Sjögren's | Ding51 |
| antiCD40L | CD40‐CD40L | Costimulatory blockade | Lupus. Abandoned due to thrombosis | Nakamura52 | |
| Anti‐IL6 (tocilizumab/MRA) | Humanised | IL‐6 | Targets the proinflammatory cytokine | RA, Crohn's, juvenile arthritis, ?lupus | Maini53 |
| CDK/GSK‐3 inhibitors | Small molecule | Multifactorial, including cell cycle arrest in proliferating cells (early trials in IgA nephropathy) | Proliferative renal disease | Soos (DNP 2006)54 | |
| Gene therapy | To restore normal T cell phenotypes | Lupus, global. | Kyttaris55 | ||
| Stem cell transplant | Lupus, global | Tyndall56 |
ANCA, antineutrophil cytoplasmic antibodies; Ig, immunoglobulin; IL, interleukin; RA, rheumatoid arthritis.