Breakthroughs and Beyond: CAR T therapy in SLE

Breakthroughs and Beyond: CAR T therapy in SLE

By Alberta Hoi

For Lani Watson, living with lupus once meant she could barely walk across a room. Diagnosed in 2022, she battled constant fatigue, joint pain, a severe skin rash, and the feeling that her own body was attacking itself. But today, thanks to a ground-breaking treatment, Lani is back playing football and living symptom-free. Her remarkable recovery using CAR T-cell therapy made national headlines – and for good reason.

CAR T therapy, short for Chimeric Antigen Receptor T-cell therapy, is a new and powerful treatment that was originally developed to treat blood cancers. It works by taking a person’s own immune cells and genetically modifying them so they can hunt down and destroy harmful immune cells. Now, researchers are testing whether this same approach can help people with severe autoimmune conditions like lupus.

In lupus, the immune system mistakenly attacks the body’s own tissues, and a type of immune cell called the B cell plays a major role. These B cells produce damaging antibodies and trigger inflammation. The version of CAR T therapy used in Lani’s trial is designed to remove nearly all B cells from the body, even the deep-seated, long-lived ones that are hard to reach with standard treatments. The idea is to give the immune system a kind of “reboot”. After the old B cells are cleared out, new ones gradually return, but they tend to look and behave more like those seen in healthy people.

It’s easy to understand why this approach has sparked so much hope.  For patients like Lani, whose disease didn’t respond to regular treatments, CAR T therapy offers real hope. But as researchers involved in these early trials emphasise, it’s not a silver bullet – and it’s not for everyone.

There are several types of CAR T-cell treatments being developed, and each one works a little differently. Before someone can receive this therapy, they need to go through comprehensive assessments, including disease activity scoring, immunological testing, and screening for potential risks. Right now, CAR T therapy for lupus is still experimental and only available through clinical trials

For most people living with lupus, conventional treatments are still the mainstay of care. Medicines like hydroxychloroquine, corticosteroids and immunosuppressants help control flares, protect organs, and improve daily life. These treatments can have side effects, but they are often essential, and they work best when combined with regular check-ups and a strong relationship with your healthcare team.

CAR T therapy is a major medical advance, but it’s also a very intensive process and currently only offered to a select group of patients with severe, hard-to-treat lupus. Even when it works well, long-term monitoring is essential, just like Lani’s 15-year follow-up plan.

The future of lupus treatment is full of promise. But for now, staying connected to your lupus specialist, sticking to your treatment plan, and acting early when symptoms change remain the keys to living well.

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