Nat Med: A new breakthrough in CAR-T cell therapy: Successfully treating multiple patients with lupus erythematosus and achieving long-term drug-free remission

Systemic lupus erythematosus (SLE) is a severe autoimmune disease with an incidence of 0.

Because B cells respond to DNA and nuclear antigens before clinical symptoms appear, dealing with systemic lupus erythematosus through B cell depletion is an attractive treatment strategy

Theoretically, deep depletion of CD19+ B cells and plasma cells in tissues may trigger an immune reset in patients with systemic lupus erythematosus, enabling the cessation of immunosuppressive therapy

On August 5, 2021, Professor Georg Schett, chair of the Department of Rheumatology and Immunology at the University of Erlangen-Nuremberg (FAU) in Germany, published a clinical research paper

The team treated a 20-year-old woman with severe systemic lupus erythematosus with CAR-T cell therapy, which gave her condition relief quickly and without significant side effects

The patient also became the first patient in the world to receive CAR-T cell therapy for systemic lupus erythematosus

Professor Andreas Mackensen (left), Professor Georg Schett (right), and in the middle is Thu-Thao V, the world's first systemic lupus erythematosus patient treated with CAR-T cells.

On September 15, 2022, the team of Professor Georg Schett and others published a research paper

In the latest paper, the research team reported that five other patients with refractory systemic lupus erythematosus improved after treatment with CAR-T cells, with no recurrence at up to 17 months of follow-up and no drug remission

In this clinical trial, five patients (4 women and 1 male) with an average age of 22 years were enrolled

All patients had histically confirmed glomerulonephritis, as well as heart, lung, and joint involvement

The team treated the five patients

After anti-CD19 CAR-T cell therapy, the researchers observed rapid and sustained remission

After 3 months of CAR-T cell administration, signs and symptoms continued to improve in all patients, including nephritis, arthritis, fatigue, heart valve fibrosis, and pulmonary

At long-term follow-up, although B cells reappeared in patients, no recurrence was observed in patients up to 17 months, while all patients remained untreated with any systemic lupus erythematosus medications

In addition, all patients experienced only mild side effects associated with CAR-T cell therapy, such as fever

Taken together, these data offer new therapeutic possibilities
for controlling system lupus erythematosus by engineering autologous cells.
However, the team said longer follow-up in larger patient cohorts is needed to determine the safety and efficacy
of CAR-T cell therapy.

Original Source:

Mackensen， A.
， Müller， F.
， Mougiakakos， D.
et al.
Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus.
Nat Med (2022).
https：//doi.
org/10.
1038/s41591-022-02017-5.