CAR T-cell therapy in SLE: A systematic review.

Area of Science:

• Immunotherapy
• Rheumatology
• Cellular Therapy

Background:

• Chimeric antigen receptor (CAR) T-cell therapy is emerging as a potent treatment for Systemic Lupus Erythematosus (SLE).
• Preliminary studies indicate promising results in small cohorts of SLE patients receiving CAR T-cell treatment.

Purpose of the Study:

• To systematically review and synthesize existing clinical evidence on CAR T-cell therapy for SLE.
• To evaluate the safety and efficacy of CAR T-cell therapy in SLE patients based on published and presented data.

Main Methods:

• A comprehensive systematic review following PRISMA guidelines was conducted.
• Searches were performed across major databases including MEDLINE (PubMed), Embase, Scopus, and CENTRAL.
• Included studies assessed safety and efficacy outcomes of CAR T-cell therapy in SLE patients.

Main Results:

• Analysis of 16 studies involving 145 SLE patients revealed significant reductions in SLE Disease Activity Index (SLEDAI) scores.
• High rates of DORIS remission (70%) and Lupus Low Disease Activity State (LLDAS) (89%) were observed.
• Cytokine Release Syndrome (CRS) occurred in 56% of patients (mostly low-grade), with rare instances of Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) and serious infections.

Conclusions:

• This systematic review confirms the substantial efficacy of CAR T-cell therapy for SLE patients.
• The findings support the potential of CAR T-cell therapy as a valuable treatment option for SLE.
• Further research is crucial to fully establish the long-term role and optimal application of CAR T-cell therapy in managing SLE.