Chimeric antigen receptor t-cell therapy for systemic autoimmune diseases: a systematic review
Abstract
Background: Systemic autoimmune diseases pose significant therapeutic challenges due to suboptimal responses and frequent relapses with conventional treatments. Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as a transformative approach, offering targeted, sustained B-cell depletion. This review evaluates its efficacy and safety in refractory systemic autoimmune conditions.
Methods: A literature search was conducted across PubMed, Scopus, and Web of Science for studies published in recent years. Eligible studies included clinical trials, observational studies, and case series assessing CAR T-cell therapy in treatment-resistant patients. Study selection and data extraction followed systematic protocols; quality was appraised using risk-of-bias tools. A narrative synthesis was performed due to heterogeneity.
Results: Emerging evidence suggests CAR T-cell therapy is associated with rapid, sustained clinical remission in severe, refractory cases, particularly Systemic Lupus Erythematosus. Consistent findings include profound B-cell depletion and significant reductions in autoantibody titres. However, the evidence base is limited by small sample sizes, short follow-up, and variable treatment protocols. Reported adverse events, including cytokine-mediated inflammatory responses and infection risk, were generally manageable but represent important safety considerations.
Conclusions: CAR T-cell therapy demonstrates promise as a novel therapeutic strategy for refractory autoimmune diseases, with the potential to redefine treatment paradigms. However, current evidence remains preliminary. Robust, large-scale studies with long-term follow-up are essential to establish safety, durability, and generalizability in broader clinical practice.
Key messages: • CAR T-cell therapy shows promise for rapid and sustained remission in severe, refractory autoimmune diseases like systemic lupus erythematosus.
• While promising, current evidence is limited by small samples and short follow-ups; large-scale studies are essential for clinical practice.
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BibTeX
@article{ofodile2026chimeric,
title = {{Chimeric antigen receptor t-cell therapy for systemic autoimmune diseases: a systematic review}},
author = {U F Ofodile and D C Davidson and O H Ezemaduka and APC Azuaru and CFO Chukwuma and EEN Ekekwe and S O Okabekwa and SNU Uwaezuoke},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1080},
url = {https://doi.org/10.1093/eurpub/ckag169.1080},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Chimeric antigen receptor t-cell therapy for systemic autoimmune diseases: a systematic review
AU - U F Ofodile
AU - D C Davidson
AU - O H Ezemaduka
AU - APC Azuaru
AU - CFO Chukwuma
AU - EEN Ekekwe
AU - S O Okabekwa
AU - SNU Uwaezuoke
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1080
UR - https://doi.org/10.1093/eurpub/ckag169.1080
AB - Background: Systemic autoimmune diseases pose significant therapeutic challenges due to suboptimal responses and frequent relapses with conventional treatments. Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as a transformative approach, offering targeted, sustained B-cell depletion. This review evaluates its efficacy and safety in refractory systemic autoimmune conditions. Methods: A literature search was conducted across PubMed, Scopus, and Web of Science for studies published in recent years. Eligible studies included clinical trials, observational studies, and case series assessing CAR T-cell therapy in treatment-resistant patients. Study selection and data extraction followed systematic protocols; quality was appraised using risk-of-bias tools. A narrative synthesis was performed due to heterogeneity. Results: Emerging evidence suggests CAR T-cell therapy is associated with rapid, sustained clinical remission in severe, refractory cases, particularly Systemic Lupus Erythematosus. Consistent findings include profound B-cell depletion and significant reductions in autoantibody titres. However, the evidence base is limited by small sample sizes, short follow-up, and variable treatment protocols. Reported adverse events, including cytokine-mediated inflammatory responses and infection risk, were generally manageable but represent important safety considerations. Conclusions: CAR T-cell therapy demonstrates promise as a novel therapeutic strategy for refractory autoimmune diseases, with the potential to redefine treatment paradigms. However, current evidence remains preliminary. Robust, large-scale studies with long-term follow-up are essential to establish safety, durability, and generalizability in broader clinical practice. Key messages: • CAR T-cell therapy shows promise for rapid and sustained remission in severe, refractory autoimmune diseases like systemic lupus erythematosus. • While promising, current evidence is limited by small samples and short follow-ups; large-scale studies are essential for clinical practice.
SN - 1101-1262
SN - 1464-360X
ER -