CAR-T cell therapy is also showing promise for rheumatological disorders where other treatments have failed or stopped working, according to four pilot studies presented at the European Alliance of Associations for Rheumatology meeting in London.
In one study, six patients with rheumatoid arthritis that had not responded to other treatments received mivocabtagene autoleucel, an experimental CAR-T cell therapy being developed by Kyverna Therapeutics. All participants had decreases in disease activity and half of them achieved sustained remission.
At follow-up ranging from 24 to 36 weeks, five of the six patients remained off immunosuppressive therapy, Fredrik Albach of Charité Universitätsmedizin in Berlin reported at the meeting.
Separately, Yajing Zhang from Beijing GoBroad Boren Hospital, China reported on 11 patients with refractory systemic sclerosis, a severe autoimmune disease that causes hardening of tissues. After administering CD19/BCMA CAR-T cell therapy, skin thickness scores and lung tissue scarring improved significantly from baseline.
“By effectively targeting both skin fibrosis and lung progression, this immunological 'reset' strategy offers true curative potential, paving the way for (mid-stage) trials to redefine the future management of this severe disease,” Zhang said in a statement.
Yuichi Maeda of the Friedrich-Alexander-Universität Erlangen-Nürnberg and colleagues tested the experimental CAR-T cell therapy zorpocabtagene autoleucel from Miltenyi Biomedicine in individuals with severe systemic lupus erythematosus, systemic sclerosis, or an autoimmune muscle disease known as idiopathic inflammatory myopathy, in an effort to improve the diversity of healthy bacteria in patients’ intestines.
Overgrowth of unhealthy bacteria “decreased to levels comparable to those of healthy controls after the treatment,” the researchers said, and the immune activity contributing to patients’ symptoms was significantly decreased.
The authors concluded that CAR T-cell therapy reshapes gut microbiota in patients with autoimmune diseases, and these immunomicrobial shifts may support long-term disease remission.
Finally, Xiaobing Wang of Shanghai Changzheng Hospital and colleagues reported that use of CAR-T cell therapy in four patients with systemic lupus erythematosus or systemic sclerosis resulted in “deep, tissue-level remission.”
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