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The aim is to explore therapeutic barriers in B-cell targeted treatments and propose a deeper understanding of immune reset mechanisms.

Revisiting B-cell targeted therapies in rheumatoid arthritis: from paradoxical biology to deep immune reset

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The aim is to explore therapeutic barriers in B-cell targeted treatments and propose a deeper understanding of immune reset mechanisms.
Review of high-resolution transcriptomic data and clinical cohort data
Analysis of EULAR and ACR guidelines surrounding rituximab usage
Assessment of early clinical data on CAR T-cell therapy for RA.
Approximately 40% of patients show non-response to rituximab.
Mechanistic failures include survival of CD20-negative plasmablasts and loss of IL-10 producing Bregs leading to increased inflammation.
CAR T-cell therapy shows promise in eradicating autoreactive memory compartments and achieving drug-free remission.

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Review analyzes B-cell therapies in rheumatoid arthritis, revealing mechanisms of resistance and strategies for immune reset.

Huang et al. (2026) studied this question.

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