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

Thursday, September 15, 2022 (HealthDay News) – While there is no cure lupus And treatments don’t work for the 1.5 million people living with the disease in the United States, and a new study shows that cancer treatment may drive hard-to-treat lupus. forgiveness.

lupus is autoimmune disease It occurs when the body’s immune system engages in friendly fire against the skin, joints, bones, kidneys, and heart, resulting in a host of symptoms.

Enter CAR-T therapy.

Used to treat certain types of cancer, the treatment takes your body’s own T cells, trains them in the lab to recognize very specific cells, and then puts them back into the body to do its job. In lupus, treatment targets CD19, a protein found on B cells.

The small study included five people with severe lupus that involves multiple organs — such as the kidneys, heart, lungs and joints — who did not respond to standard treatment.

After about three months of treatment, patients showed improvement in symptoms, including remission of organ involvement and disappearance of antibodies associated with the disease. Furthermore, they did not need any additional treatments. Similar results have been published in one person with lupus in New England Journal of Medicine in 2021.

“Severe [lupus] Very sensitive to CAR T-cell therapy [people] “You could go into drug-free remission for a long time,” said study author Dr. George Chait. He is Vice President for Research and Head of the Department of Internal Medicine at the Friedrich-Alexander-Universität Erlangen-Nuremberg in Germany.

He said the side effects in the new study were mild. In cancer studies, this type of treatment caused fever and chills, difficulty breathing, and cytokine release syndrome, which can occur when CAR-T cells multiply and release large amounts of inflammatory cytokines into the bloodstream.

Now, researchers plan to find out if immune system He has already undergone a deep reset and is behaving normally in the future.

“Longer observation of patients will be important to test whether they are in long-term disease-free remission and are eventually treated with [lupus]Chet said.

This treatment may be available sooner rather than later, he said. “Cryogenic antigen receptor T-cell therapy is already present in cancer medicine, particularly for the treatment of lymphoma and leukemia,” Schit noted.

The study was published September 15 in the journal nature medicine .

Lupus experts said they are excited about the new findings.

“This is a very, very big deal,” said Huang Nguyen, senior director of science programs at Lupus Research Alliance. Her organization supported preliminary studies looking at CAR-T therapy in a mouse model of lupus.

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

However, she cautioned, there were only five people in the trial and there isn’t enough information on the long-term effects yet.

Dr. Jill Boyon is director of the Lupus Center at NYU Langone in New York City. The patients improved with respect to multiple symptoms and did not need other treatments, including steroids. More studies are needed on larger numbers of people with lupus who are followed for longer, but this is very exciting.”

According to Dr. Ruth Fernandez Ruiz, MD, a rheumatologist at the Hospital for Special Surgery in New York City, “[Lupus] Patients had amazing clinical improvement after CAR-T cell therapy and experienced clinical remission during discontinuation… [the] Medications for follow-up duration after CAR-T-cell therapy. Despite the limited sample size, there is likely to be a role in implementing CAR-T cell therapy in [lupus]Especially for patients with severe disease that is highly refractory [resistant] to standard care therapies.”

more information

The Lupus Foundation of America has more on lupus treatments.