Systematic Review of Chimeric Antigen Receptor T-cell Therapy in Autoimmune Diseases.
Level 4 - case-series / case-control
Systematic review of uncontrolled case reports and early-phase case series
PubMed 42235055 · doi:10.1097/RHU.0000000000002354
What was done
Authors conducted a PRISMA-compliant systematic review of PubMed and other databases for publications since 2020 on CAR T-cell therapy in autoimmune diseases. Included studies were single-case reports and case series from clinical trials with extractable patient-level data.
What was found
Across 32 studies comprising 124 patients (predominantly systemic lupus erythematosus [SLE] and myasthenia gravis [MG]), 83% of SLE patients achieved clinical remission or low disease activity, and 73% of MG patients achieved minimal symptom expression within months post-infusion. CAR-T cells cleared and naive B cells reconstituted within the first few months. Mild cytokine release syndrome was the most common adverse event; serious adverse events occurred in 4.8% of patients, with zero treatment-related deaths.
Why it matters
This review aggregates early worldwide clinical experience indicating CAR T-cell therapy can induce rapid clinical responses in severe autoimmune diseases with manageable short-term toxicity.
Limits
The underlying evidence is limited to small uncontrolled case reports and case series without comparator groups, introducing high risk for publication and reporting bias. Long-term durability and rare late toxicities remain uncharacterized.
Cited by
- supports CAR-T cells engineered to eliminate B cells, which are used to treat B-cell leukemias, are showing strong responses in early clinical trials for systemic lupus erythematosus and other autoimmune diseases.