Evolution and trajectory of B-cell targeted therapies in rheumatic diseases. [Review]
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All Authors
Carter, LM.
Ehrenstein, MR.
Vital, EM.
LTHT Author
Carter, Lucy Marie
Vital, Edward
Vital, Edward
LTHT Department
Rheumatology
NIHR Leeds Biomedical Research Centre
NIHR Leeds Biomedical Research Centre
Non Medic
Publication Date
2025
Item Type
Journal Article
Review
Review
Language
Subject
Subject Headings
Abstract
Aberrant B-cell function, which could arise from various underlying causes, is central to the pathogenesis of diverse autoimmune rheumatic diseases. B cells remain the only cell type to be specifically therapeutically targeted through depletion and have the only therapy with a routinely available flow cytometric biomarker of treatment. Since first use and subsequent licensing for rheumatoid arthritis, rituximab has had a transformative impact on patients globally and across the rheumatic diseases. Further insights from B-cell-activating factor (BAFF) blockade with belimumab in systemic lupus erythematosus have followed. Examination of B-cell depletion, clinical outcomes, and re-emergent disease after treatment have deepened our understanding of the identity, detailed phenotype, biology, and kinetics of the B-cell subsets that are central to disease. This Review reflects on 20 years of clinical and translational insights drawn from B-cell targeted therapies for adult autoimmune rheumatic diseases, and highlights how these therapies have informed an exciting new era of future therapeutic developments.
Journal
The Lancet Rheumatology