Table 2.
Literature review of daratumumab use in autoimmune conditions other than autoimmune hemolytic anemia.
| Disease | N of patients | Previous treatments | Dara schedule | Time to response | Main finding | References |
|---|---|---|---|---|---|---|
| Preclinical evidence | ||||||
| Rheumatoid arthritis and systemic lupus erythematosus | 152 human samples, ex vivo study | - | Not applicable | - | Plasma cell/plasmablast-related genes CD38, XBP1, IRF4, PRDM1, IGJ, and TNFSF13B are significantly up-regulated in patients with rheumatoid arthritis and systemic lupus erythematosus | (24) |
| MM patients with autoantibodies | 6 human samples, ex vivo study | MM treatments | 16 mg/kg/week ×4 doses | After 1st infusion | Autoantibodies rapidly disappeared in 5 out of 6 patients during daratumumab treatment | (25) |
| Collagen induced arthritis | Animal model, in vivo study | – | Not applicable | – | Targeting CD38-expressing leukocytes with a cytolytic antibody can ameliorate autoimmune disease in cynomolgus monkeys | (26) |
| Clinical evidence | ||||||
| PRCA post HSCT | 1 (72-year-old man) | Steroids, rituximab, recombinant erythropoietin | 16 mg/kg/week ×6 doses | 1 week | Daratumumab induced recovery of anemia, abolishing transfusion requirement | (27) |
| ITP post HSCT for MDS | 1 (60-year-old man) | corticosteroids, vincristine, IVIG, rituximab, PEX, splenectomy, romiplostim, eltrombopag, danazol | 16 mg/kg/week ×4 doses | 8 weeks | Daratumumab induced sustained complete remission in a multi-refractory patient | (28) |
| Systemic lupus erythematosus | 2 (50- and 32-year old women) | Steroids, MMF, CyA, CTX, bortezomib, belimumab, rituximab, azathioprine, MTX, hydroxychloroquine, PEX, IVIG | 16 mg/kg/week ×4 doses | Gradual amelioration in 12 months and 10 weeks, respectively | Daratumumab provided clinical and serologic responses in two refractory patients. Daratumumab promoted depletion of autoreactive long-lived plasma cells and was associated with a reduction in interferon type I activity and with modulation of effector T-cell responses |
(29) |
| anti-CASPR2 encephalitis | 1 (60-year-old man) | Steroids, PEX, immunoadsorption, IVIG, rituximab, bortezomib | 16 mg/kg/week ×13 doses | 3 months | Daratumumab ameliorated clinical and laboratory findings of autoimmune encephalitis | (30) |
| Anti-NMDA encephalitis | 1 (20-year-old woman) | steroids, PEX, IVIG, rituximab, bortezomib | 16 mg/kg/week ×8 doses, then fortnightly ×2 doses | 2 months | Daratumumab ameliorated clinical status and the patient was able to resume everyday and self-care activities | (31) |
MM, multiple myeloma; PRCA, pure red cell aplasia; HSCT, hematopoietic stem cell transplant; ITP, immune thrombocytopenia; MDS, myelodsyplastic syndrome; CASPR2, Contactin-associated protein-like 2, NMDA, N-methyl-D-aspartate.