Daratumumab for autoimmune diseases: a systematic review
Objective Refractory autoimmune diseases remain a significant challenge in clinical practice and new therapeutic options are needed. This systematic review evaluates the existing reported data on the CD38-targeting antibody daratumumab as a new therapeutic approach in autoantibody-mediated autoimmun...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/9/4/e003604.full |
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| author | Martin Krusche Ina Kötter Lennard Ostendorf Nikolas Ruffer Marie-Therese Holzer Tobias B. Huber |
| author_facet | Martin Krusche Ina Kötter Lennard Ostendorf Nikolas Ruffer Marie-Therese Holzer Tobias B. Huber |
| author_sort | Martin Krusche |
| collection | DOAJ |
| description | Objective Refractory autoimmune diseases remain a significant challenge in clinical practice and new therapeutic options are needed. This systematic review evaluates the existing reported data on the CD38-targeting antibody daratumumab as a new therapeutic approach in autoantibody-mediated autoimmune diseases.Methods A protocolised systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases (Medline and Embase) were searched for suitable studies. Usage of daratumumab in non-oncological or non-transplantation associated diseases with autoimmune pathophysiology was analysed including patient characteristics, therapeutic regimen, adverse events and patient outcome.Results 38 publications reporting the clinical course of 83 patients met the inclusion criteria. Daratumumab usage was reported in therapy-refractory cases (median of 5 different previous therapies) in 24 different autoimmune diseases. The median number of applications of daratumumab was 4, mainly via intravenous applications (87%). Concomitant treatment included glucocorticoids in 64% of patients, intravenous immunoglobulins (33%) and rituximab (17%). Remission or improvement of disease was reported in 81% of patients. Autoantibody depletion or reduction was stated in 52% of patients. Death occurred in three patients (3%). Adverse events were reported in 45% of patients including application-associated reaction (20%), infection (19%) and hypogammaglobulinaemia (33%).Conclusion Targeting CD38 via daratumumab is a new promising therapeutic option in therapy refractory autoimmune diseases. Efficacy as well as optimal therapeutic regimen and management or prevention of adverse events require further investigation. Therefore, systematic clinical trials of this therapeutic approach are needed. |
| format | Article |
| id | doaj-art-91dfbff184434bdfb5678d0265ef3692 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-91dfbff184434bdfb5678d0265ef36922025-02-07T18:05:10ZengBMJ Publishing GroupRMD Open2056-59332023-12-019410.1136/rmdopen-2023-003604Daratumumab for autoimmune diseases: a systematic reviewMartin Krusche0Ina Kötter1Lennard Ostendorf2Nikolas Ruffer3Marie-Therese Holzer4Tobias B. Huber5Working Group Young Rheumatology, German Society for Rheumatology, Berlin, Germany9 Department of Rheumatology, Immunology and Nephrology, Asklepios Clinic Altona, Hamburg, GermanyDepartment of Nephrology and Medical Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, GermanyDivision of Rheumatology and Systemic Inflammatory Diseases, III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDivision of Rheumatology and Systemic Inflammatory Diseases, III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyIII. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyObjective Refractory autoimmune diseases remain a significant challenge in clinical practice and new therapeutic options are needed. This systematic review evaluates the existing reported data on the CD38-targeting antibody daratumumab as a new therapeutic approach in autoantibody-mediated autoimmune diseases.Methods A protocolised systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. Two databases (Medline and Embase) were searched for suitable studies. Usage of daratumumab in non-oncological or non-transplantation associated diseases with autoimmune pathophysiology was analysed including patient characteristics, therapeutic regimen, adverse events and patient outcome.Results 38 publications reporting the clinical course of 83 patients met the inclusion criteria. Daratumumab usage was reported in therapy-refractory cases (median of 5 different previous therapies) in 24 different autoimmune diseases. The median number of applications of daratumumab was 4, mainly via intravenous applications (87%). Concomitant treatment included glucocorticoids in 64% of patients, intravenous immunoglobulins (33%) and rituximab (17%). Remission or improvement of disease was reported in 81% of patients. Autoantibody depletion or reduction was stated in 52% of patients. Death occurred in three patients (3%). Adverse events were reported in 45% of patients including application-associated reaction (20%), infection (19%) and hypogammaglobulinaemia (33%).Conclusion Targeting CD38 via daratumumab is a new promising therapeutic option in therapy refractory autoimmune diseases. Efficacy as well as optimal therapeutic regimen and management or prevention of adverse events require further investigation. Therefore, systematic clinical trials of this therapeutic approach are needed.https://rmdopen.bmj.com/content/9/4/e003604.full |
| spellingShingle | Martin Krusche Ina Kötter Lennard Ostendorf Nikolas Ruffer Marie-Therese Holzer Tobias B. Huber Daratumumab for autoimmune diseases: a systematic review RMD Open |
| title | Daratumumab for autoimmune diseases: a systematic review |
| title_full | Daratumumab for autoimmune diseases: a systematic review |
| title_fullStr | Daratumumab for autoimmune diseases: a systematic review |
| title_full_unstemmed | Daratumumab for autoimmune diseases: a systematic review |
| title_short | Daratumumab for autoimmune diseases: a systematic review |
| title_sort | daratumumab for autoimmune diseases a systematic review |
| url | https://rmdopen.bmj.com/content/9/4/e003604.full |
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