Joint Ventures: The B-Cell Story, Part 1 — From Rituximab to the Next Frontier

In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, are joined by guest Lucy Carter, MBBS, PhD, a consultant rheumatologist at Newcastle upon Tyne NHS Foundation Trust and honorary clinical senior lecturer at Newcastle University, to examine nearly 2 decades of B cell–targeted therapy in rheumatic disease — a story that has proven considerably more complicated than its early promise suggested.Carter, Arnold, and Buss trace the mixed legacy of rituximab in lupus and Sjögren disease and examining how incomplete B cell depletion, BAFF-driven rebound, and trial design limitations may have contributed to disappointing early results. The discussion then turns to newer approaches such as obinutuzumab, whose positive REGENCY and ALLEGORY trial data in lupus nephritis and systemic lupus erythematosus suggest that deeper, more durable B cell depletion may improve outcomes, while emerging CAR-T data raise broader questions about the future role of intensive immune reprogramming in autoimmune disease.