[Bispecific T-cell engagers for the treatment of autoimmune diseases: Current status and therapeutic perspectives]

Bispecific T-cell engagers (BiTEs) represent a new generation of immunotherapies capable of redirecting T lymphocytes toward specific targets, particularly B cells and their plasmacytic derivatives. Initially developed in hematology for the treatment of malignant hematologic disorders, BiTEs are now attracting increasing interest in the field of severe or refractory autoimmune diseases. Their mechanism of action relies on the formation of an immunological synapse between cytotoxic T cells and B cells and/or plasma cells expressing antigens such as CD19, CD20, or BCMA, thereby reducing autoantibody production through depletion of B cells and their plasmacytic derivatives. Unlike cellular therapies, this strategy does not require genetic modification or patient-specific manufacturing, offering potential advantages in terms of depth and durability of response, while also raising questions regarding safety, feasibility, and cost. This article provides an overview of preclinical and clinical data on the use of BiTEs in autoimmune diseases and discusses the perspectives and challenges associated with their development in this therapeutic area.