Evolution and trajectory of B-cell targeted therapies in rheumatic diseases
Lancet Rheumatol, 2025. Epub ahead of print
Carter et al. review the clinical and mechanistic development of B-cell targeted therapies over the last two decades in autoimmune rheumatic diseases. B-cell depletion depth, repopulation dynamics, and immunogenicity determine long-term efficacy and inform the rationale for emerging
dual-targeted approaches, particularly in systemic lupus erythematosus where belimumab and rituximab combinations show potential to mitigate relapse driven by BAFF.
This review outlines how clinical use of rituximab and belimumab has uncovered disease-specific variation in depletion kinetics, biomarker response and relapse predictors. The authors aim to highlight how mechanistic insights from these therapies have reshaped treatment strategies and enabled development of new biologics targeting B-cell subsets and survival signals.
