A clinical trial in the UK has shown a new therapy could help treat severe lupus. It is called CAR-T cell therapy, and it is already used to treat certain cancers.
What is CAR-T cell therapy?
CAR-T cell therapy is a type of medicine called immunotherapy. Immunotherapy helps make someone’s immune system more powerful so it can fight a disease. It can also help the immune system find harmful cells or substances that are making someone ill.
Why could CAR-T cell therapy be useful for treating lupus?
Our immune system has cells called B cells and T cells. B cells normally keep people healthy by making antibodies which fight germs. However, if a person has lupus, their B cells make autoantibodies. Autoantibodies attack the person’s body instead of germs, which causes inflammation and damage.
T cells also help to fight germs, but they don’t make antibodies. Instead, T cells stick to other cells that have been infected by germs so they can be destroyed.
In CAR-T cell therapy, a person’s T cells are collected from their blood. The T cells are then changed in a lab so that they can stick to a certain type of harmful cell. For example, when CAR-T therapy is used in cancer, the changed T cells can stick to tumour cells and destroy them. The changed T cells are then put back into the person’s body.
In this recent trial, people’s T cells were changed so that they could stick to the B cells that make autoantibodies. This was to help their bodies get rid of these harmful B cells causing their lupus.
You can find out more about what happens during CAR-T cell therapy on this page. You can also watch our videos explaining CAR-T cell therapy here.
Who took part in the trial?
Nine adults took part in the trial, which was called CARLYSLE. They all had severe lupus that had not improved with any medicine. Most of them also had kidney disease caused by lupus, known as lupus nephritis.
They were all given a dose of CAR-T cell therapy. Six people were given a lower dose, and three people had a higher dose. This was to see which dose might work best.
What were the results of the trial?
- 5 out of 6 people who had the lower CAR-T therapy dose had few or no lupus symptoms after less than 9 months
- Disease activity tests showed that most people had less active lupus after CAR-T therapy
- Over half of the people with lupus nephritis who received the lower dose of CAR-T therapy had better kidney health after the treatment
What about the higher dose group?
All the results from the higher dose group are still being collected. At the moment, they are very similar to the lower dose group.
Was CAR-T safe in the trial?
The trial showed CAR-T cell therapy to be safe. Sometimes, CAR-T therapy can cause a person’s immune system to have a bad reaction. This produces lots of inflammation and can be life-threatening. There were no reactions like this in the trial.
The CAR-T cell therapy did cause liver damage in one person, but this fully healed.
What will happen next?
The trial’s researchers will carry on collecting results from everyone who took part. This is to see how long the effects of CAR-T therapy last for, and to check its long-term safety.
CAR-T cell therapy is also being tested in another clinical trial. This trial is called LUMINA. It will be like the CARLYSLE trial, but more people will take part. All the people will also have severe lupus nephritis.
There is still lots of research to be done on CAR-T cell therapy in lupus. If it is shown to be a good treatment for lupus, it will be a long time before it’s available to patients.
Learn more about CAR-T cell therapy over on our YouTube Channel!