CAR-T cell therapy for treatment-refractory rheumatic autoimmune diseases: a systematic review of clinical outcomes and safety profiles
Authors' conclusion
CAR-T therapy demonstrates substantial efficacy in treatment-refractory rheumatic diseases, achieving sustained remissions through comprehensive B-cell elimination.
Study context
- Population
- Patients with severe treatment-refractory autoimmune rheumatic disease across six rheumatic conditions (median 5 prior therapies)
- Participants
- 44 patients12 studies
- Outcome
- Clinical efficacy, safety and durability of CAR-T therapy
Methodological detailsPRISMA guidelines, risk of bias assessed with Joanna Briggs Institute tools and ROBINS-I, Five databases searched from inception to February 2025, Two reviewers independently assessed studies
- PRISMA guidelines
- Risk of bias assessed with Joanna Briggs Institute tools and ROBINS-I
- Five databases searched from inception to February 2025
- Two reviewers independently assessed studies
Pooled result
As reported in the abstract
Clinical response
Universal clinical responses achieved (% of studies)
100%
Individual response rates
92%-100%
Time to complete response
2-16 weeks
Further pooled results
Sustained drug-free remission duration
- Sustained drug-free remissions extended
- 6-46 months
Autoantibody reductions across disease-specific markers
- Profound autoantibody reductions
- 80%-99%
Safety
Cytokine release syndrome (CRS)
- CRS exclusively confined to grades 1-2; no grade ≥3 events
Immune effector cell-associated neurotoxicity
- Occurred in % of studies, predominantly grade 1 severity
- 25%
Original publication
CAR-T cell therapy for treatment-refractory rheumatic autoimmune diseases: a systematic review of clinical outcomes and safety profiles. RMD Open. Published 4 March 2026. doi:10.
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