CAR-T as a salvage treatment in polyrefractory RA
Authors' conclusion
CD19 CAR-T therapy induced profound, durable responses in extremely severe patients with seropositive PIRRA. Despite significant acute toxicities, recovery was complete and long-term safety was favourable.
Study context
- Population
- Women with long-standing, seropositive persistent inflammatory refractory RA (PIRRA) who failed ≥5 b/tsDMARD classes
- Participants
- 3 women
- Outcome
- Disease activity
- Follow-up
- Within 3 months; last (up to 18 months)
Methodological detailssingle-group, autologous anti-CD19 CAR-T with CD 28 co-stimulation, Clinical, laboratory, imaging and histological outcomes assessed up to 18 months
- Single-group
- Autologous anti-CD19 CAR-T with CD 28 co-stimulation
- Clinical, laboratory, imaging and histological outcomes assessed up to 18 months
Main finding
As reported in the abstract
Remission within 3 months
2
Low disease activity within 3 months
1
Drug-free remission at last follow-up
2
Low disease activity with abatacept and MTX at last follow-up
1
Observational data: associations, not effects.
Further findings
HAQ-DI
- Improved from severe disability to near-normal
RF and ACPA titres
- Markedly declined
Imaging and synovial histology
- Resolution of synovitis and clearance of CD19+B cells from the synovium (histological remission)
Safety
Grade 3 cytokine release syndrome
- All patients
- 3
Grade 4 ICANS
- Patients
- 1
Long-term toxicities
- None except hypogammaglobulinemia, not requiring replacement therapy
Original publication
CAR-T as a salvage treatment in polyrefractory RA. Rheumatology (Oxford). Published 24 June 2026. doi:10.
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