CAR-T cell therapy has the potential to provide sustained suppression of autoantibodies in patients with treatment-resistant lupus, according to research presented at the American College of Rheumatology’s annual meeting. The study found that CAR-T cell therapy effectively suppressed autoantibodies associated with systemic lupus erythematosus (SLE), while still allowing for a robust response to vaccines.
SLE is a complex autoimmune disease characterized by the production of autoantibodies that target DNA and nuclear proteins. It primarily affects women and is more common and severe in individuals who are Black, Hispanic, or Asian. Lupus can cause a range of systemic problems, including skin, kidney, lung, joint, and heart diseases.
Many patients with lupus require lifelong treatment with immunosuppressive or immunomodulatory drugs, but a significant number of them do not respond well to these therapies. CAR-T cell therapy, which has been successful in treating refractory blood cancers, offers a potential solution for these treatment-resistant patients.
CAR-T cells are created by genetically modifying a patient’s own T cells to produce chimeric antigen receptors (CARs). These modified T cells can then recognize and destroy specific target cells after they are infused back into the patient’s body.
Previous studies have shown that CAR-T cell therapy targeting the CD19 protein on B cells, which drive lupus flares, can lead to drug-free remission in lupus patients. The current study aimed to investigate whether this remission could be sustained and whether depleting B cells would affect the effectiveness of vaccines, which rely on B cells to generate an antibody response.
The study included eight patients who received a single dose of one million CD19 CAR-T cells per kilogram of body weight. Disease activity and autoantibody levels were monitored for up to two years. The researchers found that all eight patients achieved remission, with zero disease activity scores and no need for immunosuppressant drugs. Autoantibodies disappeared after CAR-T cell therapy and remained negative for up to 24 months after treatment, despite the re-emergence of naïve B cells.
According to the lead researcher, CAR-T therapy for lupus appears to be safer than for cancer, with fewer complications related to cytokine release syndrome. However, the therapy’s high cost is a significant barrier to widespread adoption. The cost of a single CAR-T infusion in the US can range from $375,000 to $425,000, not including associated hospital costs.
Despite these limitations, the results of this study offer hope for individuals with treatment-resistant lupus. The sustained remission achieved with CAR-T cell therapy, along with the absence of disease-associated autoantibodies, suggests that this treatment could provide long-term benefits for patients.
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it