CAR T-Cell Therapy May Treat Antisynthetase Syndrome

TOPLINE:

CD19-targeting CAR T cells may effectively treat refractory antisynthetase syndrome, according to a case study.

METHODOLOGY:

  • Previous case studies found that CD19-targeting chimeric antigen receptor (CAR) T cells were efficacious in treating autoimmune conditions such as refractory systemic lupus erythematosus.

  • CD19-targeting CAR T cells were administered to a 41-year-old male patient with antisynthetase syndrome with progressive myositis and interstitial lung disease that was not responsive to available therapies.

  • The patient received conditioning therapy before infusion with CAR T cells with fludarabine (25 mg/m2) and cyclophosphamide (1000 mg/m2).

  • Starting 35 days after CAR T-cell infusion (at 1.23 × 106/kg), the patient received mycophenolate mofetil (2 g/d).

TAKEAWAY:

  • At 8 months, there were no detectable signs of myositis on MRI.

  • The patient’s Physician Global Assessment score improved, as did his performance on muscle strength and pulmonary tests.

  • B-cell counts were low at the beginning and further decreased after CAR T-cell therapy, but recovered over time.

  • The study suggests that CAR T-cell therapy could be safe and effective in the treatment of refractory antisynthetase syndrome.

IN PRACTICE:

This case report is too preliminary to have a practical application.

SOURCE:

Ann-Christin Pecher, MD, University Hospital Tübingen, Germany, led the research. The study was published online in JAMA on June 27, 2023.

DISCLOSURES:

The study authors report financial relationships with Gilead, Novartis, and Bristol-Myers Squibb.

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