Shisha, Tamas and Gergely, Peter (2025) Redefining the Therapeutic Frontier in Autoimmune Disease. International Journal of Rheumatic Diseases, 11 (11).

Abstract

The treatment of autoimmune rheumatic diseases is entering a transformative era. Traditional immunosuppressive strategies, while effective for many, often fall short in patients with severe and refractory disease. Recent advances in the treatment landscape are redefining therapeutic possibilities, offering not just disease control but the potential for durable remission for these patients. At the forefront of this paradigm shift is the application of chimeric antigen receptor (CAR) T cell therapy—originally developed for hematologic malignancies—to severe, treatment-refractory autoimmune conditions. A landmark case report from Erlangen University followed by a case series from the same group demonstrated that autologous CD19-targeted CAR-T cells induced sustained, drug-free remission in patients with systemic lupus erythematosus (SLE), accompanied by a profound reshaping of the B cell compartment and normalization of immune signatures (Mougiakakos et al. 2021, Mackensen et al 2022). Emerging data suggests that CAR-T cells can eliminate autoreactive B cells and restore immune tolerance in autoimmune indications beyond SLE, in idiopathic inflammatory myopathies and systemic sclerosis (Schett et al. 2024). Emerging data from formal clinical trials evaluating CD19 CAR-T also suggest transformational efficacy in SLE (Morand et al, 2025) and other autoimmune diseases.

Item Type:	Article
Keywords:	autoimmune disease, immune reset; CAR-T, T cell engager
Date Deposited:	17 Feb 2026 00:45
Last Modified:	17 Feb 2026 00:45
URI:	https://oak.novartis.com/id/eprint/57886