#5-50E. Ultra-Early B-Cell Dynamics: Predicting 5-Year Rituximab Success and Refractoriness in Rheumatoid Arthritis (Ann Rheum Dis, 2026)

Can we predict rituximab's five-year efficacy in rheumatoid arthritis after just two weeks? Using high-sensitivity flow cytometry, this study of 232 patients revealed that complete plasmablast depletion at week two strongly predicts five-year drug persistence, while memory B-cell depletion failure marks early multi-drug resistance. Although this retrospective cohort is subject to selection bias due to strict follow-up criteria, the clinical implications are profound. This enables clinicians to bypass empirical wait-and-see approaches and make proactive, individualized therapy adjustments early in the disease course.

Citation: Tonutti, A., et al. High-sensitivity flow cytometry in rheumatoid arthritis shows that early B-cell subset depletion is linked to 5-year rituximab response, while failure to deplete B cells occurs early in subsequent poly-refractory disease. Annals of the Rheumatic Diseases. 2026. DOI: 10.1016/j.ard.2026.07.012

URL: https://doi.org/10.1016/j.ard.2026.07.012

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