In a small study, CAR-T therapy puts lupus into remission

THURSDAY, September 15, 2022 (HealthDay News) — While there’s no cure for lupus and treatments aren’t working for many of the 1.5 million people living with the disease in the United States, a new study shows that one cancer therapy Put difficult-to-treat lupus into remission.

Lupus is an autoimmune disease that occurs when the body’s immune system engages in friendly fire against its own skin, joints, bones, kidneys, and heart, triggering a variety of symptoms.

Enter the CAR-T therapy.

The therapy, used to treat certain types of cancer, takes the body’s own T cells, trains them in the lab to recognize very specific cells, and then infuses them back into the body to do their job. In lupus, therapy targets CD19, a protein on B cells.

The small study involved five people with severe lupus involving multiple organs — such as the kidneys, heart, lungs and joints — who had failed standard therapy.

About three months after treatment, patients showed improvements in symptoms, including remission of organ involvement and disappearance of disease-related autoantibodies. In addition, they did not need any additional treatments. Similar results in a person with lupus have been published in New England Journal of Medicine in 2021.

“Difficult [lupus] is very sensitive to CAR-T cell treatment and [people] can go into long-term drug-free remission,” says study author Dr. George Schett. He is Vice President for Research and Head of the Department of Internal Medicine at the Friedrich-Alexander University of Erlangen-Nuremberg in Germany.

Side effects in the new study were mild, he said. In cancer studies, this type of therapy has caused high fever and chills, difficulty breathing, and cytokine release syndrome, which can occur when CAR-T cells proliferate and release large amounts of inflammatory cytokines into the bloodstream.

Now the researchers want to find out whether the immune system has really gone through a deep reset and will behave normally in the future.

“Longer monitoring of patients will be important to test whether they enjoy long-term disease-free remission and are eventually cured [lupus]’ Schett said.

That treatment could be available sooner rather than later, he said. “CAR-T cell therapy is already established in cancer medicine, especially for the treatment of lymphoma and leukemia,” says Schett.

The study was published in the journal on September 15 naturopathy .

Lupus experts said they were excited by the new findings.

“This is a very, very big deal,” said Hoang Nguyen, senior scientific program manager at the Lupus Research Alliance. Your organization supported the first studies of CAR-T therapy in a mouse model of lupus.

“There is no real cure for lupus, and the effectiveness of current therapies is limited,” Nguyen said. “This is the first time that one treatment eliminated lupus symptoms in all treated subjects in a 100-day study.”

However, she warned that only five people took part in the study and there is not enough information on the long-term effects yet.

dr Jill Buyon is Director of the Lupus Center at NYU Langone in New York City. “Patients improved on multiple symptoms and did not require other therapies, including steroids. More studies are needed with larger numbers of people with lupus followed for longer, but this is very exciting,” she said.

And according to Dr. Ruth Fernandez Ruiz, a rheumatologist at the Hospital for Special Surgery in New York City, “[Lupus] Patients showed remarkable clinical improvement after CAR-T cell therapy and experienced clinical remission during the absence… [the] Medication for the duration of follow-up after CAR-T cell therapy. Despite the limited sample size, it is likely that there will be a role in the implementation of CAR-T cell therapy [lupus]particularly for patients with severe disease that is refractory [resistant] to standard treatments.”

More information

The Lupus Foundation of America has more about lupus treatments.