Third-generation CD19.CAR-T cell-containing combination therapy in Scl70+ systemic sclerosis

No effective treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD) exists. Numerous evidences support the importance of adaptive immunity in SSc-ILD. A basket trial showed higher efficacy of mycophenolate when combined with rituximab in non-specific interstitial pneumonia (NSIP), the most frequent pattern in SSc-ILD.1 Deep B-cell depletion outperforms rituximab in connective tissue diseases,2 3 prompting us to combine these principles in SSc-ILD. We here report on a 38-year-old woman suffering from Scl70+SSc with rapid progressive NSIP in which we added CD19.CAR-T-cells to a pre-existing therapy with mycophenolate/nintedanib (figure 1A). Stably elevated highly sensitive troponin T (hsTNT) levels were interpreted as mild myocardial involvement, pulmonary arterial hypertension was excluded. Except for mild obesity and a long-ago history of smoking, the medical history was empty. The disease progressed despite cyclophosphamide, mycophenolate and nintedanib. The latter was initiated because the criteria for progressive pulmonary...
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: Open access, ARD Letter Source Type: research