Anti-CD19 Monoclonal Antibody for Systemic Lupus Erythematosus and Neuromyelitis Optica Spectrum Disorder

This document presents two case reports of patients with systemic lupus erythematosus (SLE) and neuromyelitis optica spectrum disorder (NMOSD) treated with anti-CD19 monoclonal antibody, specifically inebilizumab, resulting in remission of SLE activity. The first case involved a 35-year-old man who showed improved neurological deficits and MRI findings after treatment, while the second case involved a 25-year-old woman who experienced no signs of SLE activity post-treatment, although some visual disturbances and paresthesia persisted. The discussion highlights that targeting CD19, which is expressed by more cells in the B cell lineage than CD20, may offer greater inhibition of B cell signaling and be effective for patients with coexisting SLE and NMOSD. Despite limited data, these cases suggest potential efficacy of anti-CD19 therapies in such conditions.