CD19 CAR T cell therapy for treatment-refractory seropositive rheumatoid arthritis: a phase 1 trial

CAR T-cell therapy has shown promising results in treating severe rheumatoid arthritis (RA) in an initial clinical trial. Six patients with particularly severe forms of the chronic autoimmune disorder were enrolled in the study at Charité—Universitätsmedizin Berlin. The treatment involved administering a single infusion of autologous fully human CD19 CAR T cells called miv-cel.

All six patients had previously received up to eight targeted or biologic therapies, with no significant improvement in their condition. The therapy resulted in substantial disease activity decrease in all participants, and three of the patients achieved sustained remission without requiring any medication for their RA within a year of treatment.

The trial demonstrated that CAR T-cell therapy could potentially target and reset the pathological B-cell memory, providing a fresh start for the B-cell system. Although responses varied among patients, and some cases saw disease recurrence, the safety profile of the treatment was considered encouraging. Researchers aim to compare the new treatment with an approved drug targeting B cells in a subsequent phase of the trial to assess its effectiveness and long-term impact.