Five lupus patients in 17-month remission after CAR T therapy

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Drug-free remission for up to 17 months has been demonstrated in five patients with systemic lupus erythematosus following CAR T cell therapy, according to international researchers. The team treated five patients (four women and one man) with treatment-resistant systemic lupus erythematosus with engineered anti-CD19 chimeric antigen receptor (CAR) T cells. These cells are designed to remove antibody-producing B cells by targeting the CD19 protein on their surface and reduce the harmful immune response that causes the body to attack its own cells. At follow-up (3–17 months after treatment), all patients had experienced symptom improvement, including remission of internal organ involvement, as well as disappearance of disease-related autoantibodies, with no further need for conventional therapies. Common side effects associated with CAR T cell therapy were mild (for example, fever) and no infections were observed. While further, larger studies are needed to further confirm safety and efficacy.

Journal/conference: Nature Medicine

Link to research (DOI): 10.1038/s41591-022-02017-5

Organisation/s: Friedrich Alexander University Erlangen-Nuremberg, Germany

Funder: The study was supported by the Deutsche Forschungsgemeinschaft (FOR2886, CRC1181 and TRR221), the Bundesministerium für Bildung und Forschung (BMBF; MASCARA), the European Union (ERC Synergy grant 4D Nanoscope, ERC Consolidator grant INSPIRE) and the IMI-funded project RTCure.

Media release

From: Springer Nature

1.  Health: Remission of systemic lupus erythematosus following CAR T therapy

Drug-free remission for up to 17 months has been demonstrated in five patients with systemic lupus erythematosus following CAR T cell therapy, reports a paper published in Nature Medicine.

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease that occurs in approximately 0.1% of the global population, with a high prevalence in young women. This lifelong condition is driven by autoantibodies — immune defense molecules that attack the body’s own cells — and affects the joints and skin, potentially causing severe damage to organs, including the kidneys, brain and heart. Most patients are treated with glucocorticoids and therapies that target T cells or antibody-producing B cells. However, these treatments are frequently ineffective and no curative therapy is currently available.

Georg Schett and colleagues treated five patients (four women and one man; median age of 22 years) with treatment-resistant SLE with engineered anti-CD19 chimeric antigen receptor (CAR) T cells. These cells are designed to remove antibody-producing B cells by targeting the CD19 protein on their surface. At follow-up (3–17 months after treatment), all patients had experienced symptom improvement, including remission of internal organ involvement, as well as disappearance of disease-related autoantibodies, with no further need for conventional therapies. Common side effects associated with CAR T cell therapy were mild (for example, fever) and no infections were observed.

Although these findings may highlight a new therapeutic option for patients with SLE, longer follow-up in larger clinical trials is needed to determine the safety and efficacy of CAR T cell therapy in this context.

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