Sensitive B-cell receptor repertoire analysis shows repopulation correlates with clinical response to rituximab in rheumatoid arthritis
Authors' conclusion
Our findings indicate that rather than BCR-depletion it is repopulation with unmutated BCRs, possibly from naïve B cells, which induces remission.
Study context
- Population
- Rheumatoid arthritis (RA) patients undergoing rituximab therapy; peripheral blood samples
- Participants
- 28 patients
- Exposure
- Early vs late B-cell receptor (BCR)-depletion and early vs late BCR-repopulation after rituximab
- Outcome
- Predictive value of early BCR-depletion and early BCR-repopulation on clinical response
Methodological detailsB-cell receptor repertoire analysis
- B-cell receptor repertoire analysis
Main finding
As reported in the abstract
- Early BCR depletion was not associated with early clinical response but late depleters did show early response
- Patients with early repopulation with unmutated BCRs showed a significant decrease in disease activity in the interval 6 to 12 months
Observational data: associations, not effects.
Further findings
Peripheral blood BCR repertoire after rituximab · up to 12 months
- Increased clonal expansion, decreased clonal diversification and increased mutation load, persisting up to 12 months but starting to revert at month 6
Anti-drug antibodies and BCR repopulation
- Development of anti-drug antibodies non-significantly correlated with more BCR repopulation
Original publication
Sensitive B-cell receptor repertoire analysis shows repopulation correlates with clinical response to rituximab in rheumatoid arthritis. Arthritis Res Ther. Published 16 March 2024. doi:10.
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