Good news in lupus: remission in five patients after CAR-T therapy

Lupus, a chronic disease in which the immunity system of the patient attacks different organs and tissues causing damage and inflammation, remains a mystery to doctors. It affects approximately 0.1% of the world population, with a high prevalence in young women.

It is caused by autoantibodies – immune defense molecules that attack the body’s own cells – and damages joints and skin, and can cause serious deterioration in organs such as the kidneys, brain and heart.

Most patients are treated with glucocorticoids and therapies that target antibody-producing T cells or B cells. Although, at the moment there is no curealthough it can be controlled with drugs capable of regulating the immune system and containing inflammation.

In addition, the recent arrival of new biological therapies has opened new avenues of treatment that will improve patients’ quality of life. This is the case for CAR-T cells.

According to a study published today in the journal natural medicinedrug-free remission of up to 17 months after this treatment was demonstrated in five patients with systemic lupus erythematosus.

How CAR-T cells work

To arrive at these promising findings, the research team, led by Georg Schettfrom the University of Erlangen-Nuremberg (Germany), treated five patients (four women and one man) with treatment-resistant systemic lupus erythematosus. T cells with chimeric antigen receptors (CAR) anti-CD19.

According to the authors, these cells are designed to eliminate antibody-producing B lymphocytes by targeting the CD19 protein on their surface.

During follow-up (between 3 and 17 months after treatment), all patients showed improvement in symptoms, including remission of internal organ involvement, as well as disappearance of disease-related autoantibodies, without the need to continue receiving conventional therapies.

The team notes that the usual side effects associated with CAR-T cell therapy were mild (eg, fever) and no infections were observed.

More studies to prove its safety

Although these results may constitute a new therapeutic option for patients with this condition, longer follow-up is needed in larger clinical trials to determine the safety and effectiveness of CAR-T cell therapy in this setting, the researchers say.