CD19-targeting CAR T-cell therapy in patients with diffuse systemic sclerosis: a case series

Area of Science:

• Immunology
• Rheumatology
• Cell Therapy

Background:

• CD19-targeting chimeric antigen receptor (CAR) T-cell therapy demonstrates success in systemic lupus erythematosus.
• The impact of CAR T-cell therapy on systemic sclerosis organ manifestations requires further investigation.
• B cells play a critical role in the development of systemic sclerosis.

Purpose of the Study:

• To analyze the effects of CD19-targeting CAR T-cell therapy on organ manifestations in patients with systemic sclerosis.
• To evaluate the safety and efficacy of CAR T-cell therapy in severe systemic sclerosis.

Main Methods:

• Six patients with severe diffuse systemic sclerosis received CD19-targeting CAR T-cell treatment.
• Primary outcome: event-free time or treatment intensification.
• Secondary outcomes: changes in modified Rodnan Skin Score (mRSS), lung imaging, laboratory assessments, patient-reported outcomes, and ACR-CRISS.

Main Results:

• No adverse events or disease progression occurred during the observation period.
• Significant improvements observed in ACR-CRISS scores, mRSS, and forced vital capacity.
• CT scans showed a reduction in ground-glass opacities, indicating decreased lung inflammation.

Conclusions:

• CD19-targeting CAR T-cell therapy may halt the progression of fibrotic organ damage in systemic sclerosis.
• This therapy represents a potential new treatment avenue for systemic sclerosis.
• Further research is warranted to confirm these findings in larger cohorts.