#6-03E. Unlocking Nonresponse: Molecular Predictors of B-Cell Therapy in Sjögren's Disease (Arthritis Rheumatol, 2026)

Why do patients with primary Sjögren's disease exhibit such divergent clinical responses to B-cell-targeted therapies? Whole blood transcriptomic profiling reveals that clinical nonresponse is driven by distinct, B-cell-independent baseline molecular pathways—specifically complement regulation and TGF-β remodeling in ESSDAI nonresponders, versus an IL-1/IL-18 myeloid axis in STAR nonresponders. Although these findings stem from a small female subcohort (n=43) and require prospective validation, they provide clinicians with a critical molecular rationale to stratify patients and consider alternative, non-B-cell therapeutic targets in refractory cases.

Citation: Ibrahim A, Peng J, Tian E, Martin-Gutierrez L, Casement J, Thompson K, Ng WF, van Maurik A, Jury EC, Ciurtin C. Treatment-Driven Peripheral Blood Transcriptomic Remodeling and Baseline Predictors of ESSDAI and STAR Response to B Cell Therapy in Sjögren's Disease. Arthritis & Rheumatology. 2026.

DOI: 10.1002/art.70354

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