Combined B cell/T cell therapy as novel approach for the re-induction of humoral immune-tolerance
Despite advances in the treatment of rheumatoid arthritis (RA) and the development of effective anti-inflammatory therapies, this chronic inflammatory autoimmune disease remains incurable. In the proposed clinical trial, we plan to sequentially use combined B-cell and T-cell therapy. ACPA-positive RA patients receive therapy with rituximab for B-cell depletion and subsequent blockade of T-cell co-stimulation by administration of abatacept. The primary endpoint of this study is the proportion of anti-cyclic citrullinated (CCP) 2 antibody seroconversions in anti-CCP2 positive RA patients at a given time, while secondary outcomes will be changes in autoantibody glycosylation as well as B cell response as well as the effects on clinical disease activity.