Standard treatments, such as corticosteroids, antimalarials, and immunosuppressants, usually require long-term use and can have many drawbacks, including increased risk of infections, osteoporosis, infertility, and organ damage. Even newer biologics, such as belimumab, may take months and they rarely achieve full disease remission, with fewer than 10% of patients reaching complete remission in one year in clinical trials.
While conventional therapies suppress the immune system, CAR T-cell therapy is a targeted approach, which will likely lead to better results. In 2021, a pilot study in Germany treated a 20-year-old woman with severe, refractory SLE, a type of SLE that doesn’t respond well to standard treatments. With the CAR T-cells, she showed complete B-cell depletion within 44 days, normalization of autoantibodies, and clinical remission all with no major side effects.
That same year, five young adults with refractory SLE underwent CAR T therapy. Within three months, all patients achieved disease remission as measured by the SLE Disease Activity Index (SLEDAI), which dropped to near-zero levels. Indicators of disease, such as protein in urine and low complement proteins, returned to normal. Additionally, the only notable side effect was mild fever, which was resolved with antipyretics. Importantly, none of the patients experienced neurotoxicity, a concern in cancer CAR T therapies. Long-term follow-up showed that remission persisted even after B cells naturally returned, reflecting a “reprogramming” of the immune system.
Additionally, in June 2024, Monash Hospital in Melbourne treated 33-year-old Lani Watson, who had become wheelchair-bound due to severe lupus. After receiving CAR T-cell therapy, her symptoms resolved, and she regained full mobility. She has remained in remission and has been medication-free since treatment.
