- It is estimated that 1.5 million people in the United States suffer from lupus.
- There is no known cure and there are few effective treatments for this disease.
- Researchers report that a new CAR T-cell immunotherapy has shown promising results in a recent study.
- Experts said the study is promising, but more research is needed.
Five patients with lupus who were treated with a form of immunotherapy known as CAR T-cell therapy reportedly achieved complete remission within months of their treatment.
“These data indicate that CD19 CAR T-cell transfer is feasible, acceptable, and highly effective in SLE,” the study authors wrote.
“However, longer follow-up in larger groups of patients will be necessary to confirm the persistent absence of autoimmunity and resolution of inflammation in SLE patients who received T-cell therapy,” they added.
CAR T-cell therapy is a form of immunotherapy commonly used to treat cancer.
During CAR T-cell therapy, a person’s blood is taken to collect T cells, a type of immune system cell. These cells work by traveling around the body to destroy damaged cells, such as cancer cells.
In CAR T cell therapy, some of these cells are taken and modified in the laboratory so that they can attack a new target. They are then given back to the person by intravenous injection.
In lupus, immune cells called B cells make autoantibodies that attack healthy tissue. In the new study, the T cells were modified so that when re-injected into the patient’s body they targeted a protein called CD19, which is found in B cells that attack healthy tissue.
The researchers reported that CAR T-cell therapy was highly effective in destroying B cells that had previously been attacking healthy tissue, with B cells disappearing completely on the second day after CAR T-cell therapy.
Study participants had not previously responded to a number of other immunosuppressive treatments.
However, with CAR T-cell therapy, they saw improvement in a number of severe symptoms and were able to stop their lupus medications.
The researchers reported that even when the B cells reappeared after treatment, the participants continued to be disease free with no episodes of lupus. The researchers reported that the re-emerging B cells were naive, meaning they were not yet specific for an antigen (target) like the previous B cells.
Dr. Chris WinkebeA consultant rheumatologist at King’s College Hospital London and a clinical research fellow at University College London says that although more study is needed on a larger group, the results are important.
“The fact that this treatment worked, first, is very interesting, as these patients had already been through a really robust and conventional treatment,” he told Healthline. “The fact that this has actually put them in remission, is really a OK thing. And also the fact that they have been able to get complete remission within three months after being resistant to many of the powerful and traditional treatments we use.”
“It really does show the potential for this to be a new treatment option for patients with lupus who have very severe and intractable disease,” Winkbe added.
it is expected that 1.5 million People in the United States have lupus, 90% of whom are women. Systemic lupus erythematosus (SLE) is the most common form of SLE.
Lupus causes the immune system to attack the body’s tissues, resulting in inflammation and tissue damage in the organs. The blood vessels, joints, lungs, kidneys, brain, and skin can be affected by lupus.
There is no cure for lupus and experts say more treatment options are needed.
“There is a huge unmet need for better treatments for people with lupus,” Dr. Sean O’Neill, an associate professor of rheumatology at Royal North Shore Hospital and the University of Sydney in Australia, told Healthline. “Current options when it comes to standard care include medications like prednisone and steroid medications that cause a lot of side effects, and people usually take them for a very long time. So they have a lot of problems, like osteoporosis, high blood sugar, and associated cardiovascular disease. with steroids.”
“Although they can be very effective for some people, there are many, many patients who have active lupus despite those treatments, or have some active disease and toxicity from their treatments,” O’Neill added.
The researchers said further study with larger groups of participants and longer follow-up periods is needed to ensure the efficacy and safety of CAR T-cell therapy for people with lupus.
Experts who spoke with Healthline say that while the study represents an exciting new avenue for exploration, it will take some time for something like CAR T-cell therapy to become a standard treatment for people with lupus.
Both indicated that the cost of CAR T-cell therapy is likely to be significant, which may limit the group of people for whom the treatment is appropriate.
“One of the tricky things about CAR T-cell therapy is that it’s very expensive,” Winkbe said. “So making this widely available when we have other, cheaper drugs that may be effective in many cases means that this may only be used in more severe patients who haven’t responded to some of the treatments we already have.”