A new study suggests that a cancer medication may put lupus that is difficult to treat into remission, despite the fact that there is no cure for the condition and that medicines are ineffective for many of the 1.5 million people who live with it in the United States.
A variety of symptoms are brought on by lupus, an autoimmune illness that develops when the immune system of the body attacks its own skin, joints, bones, kidneys, and heart.
Introducing CAR-T treatment.
The therapy employs your body’s own T-cells as a starting point, trains them in the lab to identify certain specific cells, and then reintroduces them into the body to carry out their function. The treatment for lupus specifically targets the B cell protein CD19.
Five patients with severe lupus encompassing many organs, including the kidneys, heart, lungs, and joints who had not responded to usual medication were included in the tiny trial.
Patients began to experience improvements in their symptoms about three months after receiving one therapy, including a remission of organ involvement and the removal of disease-related autoantibodies. They also didn’t require any more treatments. The New England Journal of Medicine published similar findings in a single lupus patient in 2021.
According to study author Dr. Georg Schett, “severe [lupus] is particularly susceptible to CAR-T cell treatment, and [patients] can go into long-lasting drug-free remission.” He serves as the department of internal medicine’s chair and the vice president for research at Germany’s Friedrich-Alexander University Erlangen-Nürnberg.
According to him, the new study’s side effects were minimal. This form of therapy has been linked to high fever, chills, difficulty breathing, and cytokine release syndrome, which can occur when CAR-T cells proliferate and release a lot of inflammatory cytokines into the bloodstream.
In the future, scientists want to know if the immune system has truly undergone a deep reset and behaves normally.
In order to determine if patients experience long-term disease-free remission and ultimately recover from [lupus], longer patient monitoring will be crucial, according to Schett.
He suggested that this medicine might become available sooner rather than later. Schett stated that “CAR-T cell therapy is already well established in the field of oncology, particularly for the treatment of lymphoma and leukaemia.”
The research was released on September 15 in the magazine Nature Medicine.
Experts on lupus expressed their excitement over the fresh information.
Hoang Nguyen, senior scientific programme manager of the Lupus Research Alliance, declared, “This is a very, very huge deal. Her group funded the initial experiments examining CAR-T treatment in a lupus animal model.
Lupus has no true treatment, and the efficacy of available medicines is constrained, according to Nguyen. This was the first medication that, during the course of a 100-day study, completely removed all treated participants’ lupus symptoms.
She emphasised that there were only five participants in the research and that more data on the long-term impacts is still lacking.
Director of the Lupus Center at NYU Langone in New York City is Dr. Jill Buyon. “Patients improved in terms of a variety of symptoms and didn’t need additional treatments, such as steroids. This is quite promising, but more trials in larger groups of lupus patients who are followed for longer are required,” she said.
A rheumatologist at the Hospital for Special Surgery in New York City named Dr. Ruth Fernandez Ruiz says that “[Lupus] patients had striking clinical improvement after CAR-T cell therapy and experienced clinical remission while off… [the] drugs for the duration of follow-up after CAR-T cell therapy.” Despite the small sample size, it is likely that CAR-T cell therapy will play a position in the treatment of lupus, especially for patients who have severe illness that is resistant to standard-of-care medications.
For more information on lupus therapies, visit the Lupus Foundation of America.
SOURCES: Ruth Fernandez Ruiz, MD, rheumatologist, Hospital for Special Surgery, New York City; Georg Schett, MD, vice president, research, chair, department of internal medicine, Friedrich-Alexander University Erlangen-Nürnberg, Nürnberg, Germany; Jill Buyon, MD, rheumatologist, director, Lupus Center, NYU Langone, New York City; Hoang Nguyen, PhD, senior scientific programme manager, Lupus Research Alliance