What you should know about the new study titled: “Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus”.
Paper Reviewed by Dr Andrew R Benck and Dr Dmitriy Cherny (Rush Lupus Clinic)
The causes of lupus are complex, but it is known that a type of immune cell called a B-Cell, is thought to play a central role in lupus. For some patients, existing treatments are not able to control their disease, leading to devastating consequences. These patients are said to have “refractory lupus.” In these cases, experimental treatments are sometimes given. One such treatment is CAR T therapy (1). The CAR T stands for “chimeric antigen receptor T-Cell”. This is a treatment which has classically been used to treat certain types of blood cancer. The treatment works like this: A sample of a patient’s blood is taken, and special immune cells known as T-Cells are isolated from that blood sample. Those T-Cells are then modified in a lab to attack very specific targets in the body. The modified T-Cells are then infused back into the patient and attack the B-cells that were mentioned earlier.
This study tested CAR-T therapy in 5 patients with refractory lupus. The results were dramatic and favorable, leading to lupus remission in all 5 patients who were given it. These patients tolerated the treatment well, without serious side effects. However, it is known from frequent use in cancer treatment that CAR-T therapy carries numerous risks, including infection and nervous system problems. It is therefore not a treatment option that should be taken lightly. Overall, we are very encouraged by the results of this study. But larger studies in refractory lupus are certainly required before we can endorse it safely for our patients.
[1] Mackensen, Andreas, et al. “Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus.” Nature Medicine (2022): 1-9.
