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Published on: May 16, 2025
[Rheumatology: what's new in 2024]
1Service de rhumatologie, HFR Fribourg, 1708 Fribourg.
Abstract:
In 2024, CD19-CAR T cells are ubiquitous in rheumatology, with incredible therapeutic results in cases of severe and refractory disease. This major advance confirms the interest of the B lymphocyte as a therapeutic target, and also suggests the real possibility of a drug-free remission, at the price of minor and minimal side effects for the time being. However, the necessary perspective is still lacking for a therapy that remains out of reach because of its price. On the other hand, the availability of targeted treatments offering real corticosteroid sparing benefits seems imminent for gigantocellular arteritis and polymyalgia rheumatica, with very promising results and treatments already used on a daily basis, notably JAK inhibitors, anti-IL17 and sarilumab.
Insights
CD19-CAR T cell therapy shows remarkable results in severe rheumatology, offering potential drug-free remission. However, high costs and limited long-term data remain challenges, while new targeted treatments emerge for specific inflammatory conditions.
Area of Science:
- Immunotherapy
- Rheumatology
Context:
- CD19-CAR T cells are increasingly utilized in rheumatology for severe, refractory diseases.
- B lymphocyte targeting shows significant therapeutic potential.
Purpose:
- To review the current status and future prospects of CD19-CAR T cell therapy in rheumatology.
- To discuss emerging targeted therapies for giant cell arteritis and polymyalgia rheumatica.
Summary:
- CD19-CAR T cell therapy demonstrates impressive efficacy and tolerability in severe autoimmune conditions, hinting at drug-free remission possibilities.
- Despite its success, high costs and the need for long-term outcome data limit its accessibility.
- Targeted treatments like JAK inhibitors, anti-IL17, and sarilumab are nearing availability for giant cell arteritis and polymyalgia rheumatica, offering corticosteroid-sparing benefits.
Impact:
- Advances in CAR T-cell therapy offer new hope for patients with difficult-to-treat rheumatic diseases.
- Emerging targeted therapies promise improved management and reduced reliance on corticosteroids for specific inflammatory conditions.
- The high cost of CAR T-cell therapy necessitates further research into accessibility and cost-effectiveness.
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