Sjögren's disease & overlap diseases
Serum and Tissue Biomarkers Associated With Composite of Relevant Endpoints for Sjögren Syndrome (CRESS) and Sjögren Tool for Assessing Response (STAR) to B Cell–Targeted Therapy in the Trial of Anti–B Cell Therapy in Patients With Primary Sjögren Syndrome (TRACTISS)
Authors' conclusion
Rituximab modulates both peripheral and SG inflammation, preventing the deterioration of exocrine function with functional and metabolic restoration of the glandular epithelium. Response assessed by newly developed cCRESS and STAR criteria was associated with differential modulation of peripheral and SG biomarkers
Study context
- Population
- Patients with primary Sjögren syndrome in the TRACTISS trial; peripheral blood and salivary gland biopsies pre- and post-treatment
- Comparison
- Rituximab vs placebo; Concise Composite of Relevant Endpoints for Sjögren Syndrome (cCRESS) and STAR responders vs non-responders
Methodological detailslongitudinal, flow cytometry immunophenotyping, serum cytokines, salivary gland (SG) bulk RNA sequencing
- Longitudinal
- Flow cytometry immunophenotyping
- Serum cytokines
- SG bulk RNA sequencing
Primary result
As reported in the abstract
- Rituximab prevented the worsening of SG inflammation seen with placebo, by inhibiting accumulation of class-switched memory B cells within the SG
- Rituximab significantly down-regulated genes for immune-cell recruitment, lymphoid organization, antigen presentation and T cell co-stimulatory pathways
- Rituximab down-regulated peripheral immunoglobulins, auto-antibodies, pro-inflammatory cytokines and chemokines
- STAR responders had significantly higher baseline CXCL13, IL-22, IL-17A, IL-17F and TNF-α
- Serum T cell-related cytokines showed a selective reduction in both STAR and cCRESS responders
- cCRESS responders showed a significant decrease in SG B cell infiltration and reduced expression of gene modules for T cell costimulation, complement activation and Fcγ-receptor engagement
- cCRESS and STAR response associated with significant improvement in SG exocrine function, linked to transcriptional evidence of SG epithelial and metabolic restoration
Original publication
Serum and Tissue Biomarkers Associated With Composite of Relevant Endpoints for Sjögren Syndrome (CRESS) and Sjögren Tool for Assessing Response (STAR) to B Cell–Targeted Therapy in the Trial of Anti–B Cell Therapy in Patients With Primary Sjögren Syndrome (TRACTISS). Arthritis Rheumatol. Published 15 February 2024. doi:10.
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