Residual inflammation after rituximab treatment is associated with sustained synovial plasma cell infiltration and enhanced B cell repopulation

Abstract

The present study demonstrated that a low disease activity state following rituximab was associated with reduced infiltration of CD79a+ CD20- plasma cells in synovium and reduced B cell repopulation.

Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis

“…Rituximab leads to transient but almost complete depletion of B cells in the blood and only partial depletion in the bone marrow8–13 and synovial tissue 14–16. Response has been shown to correlate with the level of synovial membrane B-cell depletion9 and early peripheral blood depletion of B cells measured by sensitive assays,9 possibly useful as a surrogate.…”

Long-term Outcomes of Rituximab Therapy in Ocular Granulomatosis with Polyangiitis

“…28,29 This is further underscored by the presence of B cells in the joints and salivary glands of patients with rheumatoid arthritis and Sjögren's syndrome, respectively, sites that are also resistant to depletion by RTX. 30,31 These B cells may eventually die and not be replenished because of systemic depletion, thus explaining the delay in the effect of RTX.…”

Implication of B lymphocytes in the pathogenesis of ANCA-associated vasculitides

“…Interestingly, an in vitro non-depleting study also demonstrated a better efficacy of rituximab on CD27 -naive B-cells compared to CD27 + memory B regarding B-cell activation, proliferation, and viability [107]. Few months after the first injection of rituximab, transitional B-cells repopulation is observed and plasma cells recirculate in the peripheral blood of treated patients [108,109]. Moreover, notably in rheumatoid arthritis patients, a high proportion of circulating memory B-cells is associated with increased risk of relapse in patients receiving rituximab [108,110].…”