CAR T-cell therapy induces medication-free remission in severe rheumatoid arthritis

In the first clinical study of its kind, Charité - Universitätsmedizin Berlin tested CD19-directed CAR T-cell therapy in six patients with treatment-refractory rheumatoid arthritis, ages 31 to 69, who had previously tried up to eight biologic agents. After a brief preparatory chemotherapy, each patient received a single infusion of their own T cells engineered to recognize the CD19 marker on harmful B cells. Disease activity fell sharply in every case, and three participants sustained medication-free remission for as long as twelve months.

Laboratory analyses indicated that the therapy cleared CD19-positive B cells from joints, bone marrow and lymph nodes, allowing a new, naïve B-cell repertoire to repopulate while preserving antibodies from earlier vaccinations. Adverse events were limited to transient, manageable cytokine release syndrome, with no severe neurological issues or frequent infections reported. A follow-up phase will enroll ten additional patients and directly compare CAR T-cell therapy to an existing CD20-targeting rheumatoid arthritis drug, aiming to confirm whether the cellular approach offers superior or longer-lasting disease control.