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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-09-04T21:30:00.465">September 4, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Review: CAR T Cells Could Transform Pediatric SLE Therapy</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/jared-kaltwasser">Jared Kaltwasser</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Review: CAR T Cells Could Transform Pediatric SLE Therapy" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" 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M20,39V26.6l12,9.3l12-9.3V39H20z" fill="white"></path></svg></button><a class="print-wrap flex justify-center items-center cursor-pointer"><svg id="print" xmlns="http://www.w3.org/2000/svg" width="24" height="24" fill="currentColor" class="print bi bi-printer" viewBox="0 0 16 16"> <path d="M2.5 8a.5.5 0 1 0 0-1 .5.5 0 0 0 0 1z"></path> <path d="M5 1a2 2 0 0 0-2 2v2H2a2 2 0 0 0-2 2v3a2 2 0 0 0 2 2h1v1a2 2 0 0 0 2 2h6a2 2 0 0 0 2-2v-1h1a2 2 0 0 0 2-2V7a2 2 0 0 0-2-2h-1V3a2 2 0 0 0-2-2H5zM4 3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1v2H4V3zm1 5a2 2 0 0 0-2 2v1H2a1 1 0 0 1-1-1V7a1 1 0 0 1 1-1h12a1 1 0 0 1 1 1v3a1 1 0 0 1-1 1h-1v-1a2 2 0 0 0-2-2H5zm7 2v3a1 1 0 0 1-1 1H5a1 1 0 0 1-1-1v-3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1z"></path></svg></a></div><style> .print-wrap { width: 32px; height: 32px; background: #7F7F7F; border-radius: 100%; } .print { background: #7F7F7F; color: white; padding: 2px; border-radius: 100%; } </style></div></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><p class="py-2 mb-2 text-sm italic text-gray-600">Early data suggest chimeric antigen receptor (CAR) T-cell therapy can achieve meaningful long-term results.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">A novel <a target="_blank" href="https://www.ajmc.com/compendium/gene-therapy">cell therapy</a> that first emerged as a treatment for hematological malignancies may be an effective treatment option for children with systemic lupus erythematosus (SLE), a new report indicates.</p><p class="pb-2">A <a rel="nofollow noreferrer noopener" target="_blank" href="https://ped-rheum.biomedcentral.com/articles/10.1186/s12969-024-00990-4">review article in </a><a rel="nofollow" target="_self" href="https://ped-rheum.biomedcentral.com/articles/10.1186/s12969-024-00990-4"><em>Pediatric Rheumatology</em></a> suggests chimeric antigen receptor (CAR) T-cell therapy may address some of the shortcomings of existing SLE therapies, thereby improving long-term patient outcomes.<sup class="text-inherit">1</sup></p><div class="flex justify-center"><div style="width:30%;float:;max-width:525px;margin:0 auto 1rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%271200%27%20height=%27724%27/%3e"/></span><img alt="Genetic analysis | Image Credit: © angellodeco - stock.adobe.com" title="Genetic analysis | Image Credit: © angellodeco - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Genetic analysis | Image Credit: © angellodeco - stock.adobe.com" title="Genetic analysis | Image Credit: © angellodeco - stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F86002120662bc086c89a9494427508ac7a4ceea2-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F86002120662bc086c89a9494427508ac7a4ceea2-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F86002120662bc086c89a9494427508ac7a4ceea2-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">CAR T-cell therapy may address some of the shortcomings of existing SLE therapies, thereby improving long-term patient outcomes | Image Credit: © angellodeco - stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/86002120662bc086c89a9494427508ac7a4ceea2-1200x724.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">Corresponding author Ivana Stojkic, MD, of Nationwide Children’s Hospital, and colleagues, explained that a diagnosis with SLE in childhood is associated with increased morbidity and mortality compared with adult cases. One of the most dangerous complications, they noted, is lupus nephritis (LN).</p><p class="pb-2">“Lupus nephritis in particular carries significant morbidity and has an increased prevalence and severity in children and adolescents compared to adults,” they explained.</p><p class="pb-2">Though the armamentarium for treating SLE has increased in recent years, the authors said survival rates have “plateaued.” Nearly one-quarter (22%) of children with SLE who develop end-stage kidney disease as a result of LN will die within 5 years, they said.</p><p class="pb-2">A <a rel="nofollow" target="_self" href="https://www.ajkd.org/article/S0272-6386(21)00825-8/abstract">2022 report</a> that compared outcomes of children on dialysis due to LN to those of children on dialysis for nonlupus glomerular disease found children with LN had worse outcomes, were more likely to be hospitalized during their first year on dialysis, and were less likely to receive a kidney transplant in their first 3 years on dialysis.<sup class="text-inherit">2</sup></p><p class="pb-2">Children with SLE are typically treated with long-term high-dose glucocorticoids and immunosuppression, which can themselves lead to adverse effects and infections.</p><p class="pb-2">“Therefore, there remains a significant unmet need for new therapies that can improve disease control and reduce glucocorticoid and other toxic medication exposure for these patients,” Stojkic and colleagues said.<sup class="text-inherit">1</sup></p><p class="pb-2">Recent attention has focused on the role of B-cell dysregulation and autoantibody production in the pathogenesis of the disease. Two B-cell targeting therapies—rituximab (Rituxan) and belimumab (Benlysta)—have shown efficacy in patients with SLE, but Stojkic and colleagues said many patients do not achieve an adequate response with those therapies. One reason, they said, could be incomplete B-cell depletion or an inability to target long-lived antibody-producing plasma cells.</p><p class="pb-2">CAR T-cell therapy involves collecting T cells, re-engineering them to target a specific antigen, and then infusing them back into the patient. Though the first wave of CAR T-cell therapies have focused on cancers like B-cell non-Hodgkin lymphoma and multiple myeloma, investigators have begun to consider a wider array of indications for the therapies.</p><p class="pb-2">In a murine model of SLE, anti-CD19 CAR T cells <a rel="nofollow" target="_self" href="https://www.nature.com/articles/s41423-020-0472-1">were found</a> to spark sustained B-cell depletion leading to therapeutic benefits.<sup class="text-inherit">3</sup> Furthermore, the authors of that study also found the therapy showed preventative effects when given to mice before the onset of disease.</p><p class="pb-2">Investigation of CAR T cells in human subjects with SLE has been limited, the authors said, but the early data are promising. Earlier this year, investigators studying the impact of CAR T-cell infusion in patients with 3 autoimmune diseases, including SLE, <a rel="nofollow" target="_self" href="https://www.nejm.org/doi/10.1056/NEJMoa2308917">published results</a> showing the therapy to be feasible, safe, and effective.<sup class="text-inherit">4</sup> That study included 5 young adults (ages 18-24 years) with SLE, and found the therapy led to sustained depletion of circulating B cells, along with control of LN and a decrease in SLE Disease Activity Index scores.</p><p class="pb-2">Other reports have found similarly positive results. In addition, Stojkic and colleagues said, the patients with SLE who have received CAR T-cell therapies have tended to have less severe side effects, such as cytokine release syndrome (CRS).<sup class="text-inherit">1</sup></p><p class="pb-2">“The safety profile to date for the SLE population is more favorable compared to the oncology population due to a smaller target T cell population, and therefore a lower underlying risk of CRS,” they wrote.</p><p class="pb-2">The investigators said more research will be needed to better understand the therapy’s long-term safety and efficacy in children with SLE. They said controlled clinical trials are warranted, but said those trials should include both adult and pediatric patients with SLE, given the potentially life-changing impacts of successfully treating SLE in younger patients.</p><p class="pb-2"><strong>References</strong></p><ol class="my-2"><li class="list-decimal ml-8">Stojkic I, Harper L, Coss S, et al. CAR T cell therapy for refractory pediatric systemic lupus erythematosus: a new era of hope? <em>Pediatr Rheumatol Online J</em>. 2024;22(1):72. doi:10.1186/s12969-024-00990-4</li><li class="list-decimal ml-8">Wasik H, Chadha V, Galbiati S, Warady B, Atkinson M. Dialysis outcomes for children with lupus nephritis compared to children with other forms of nephritis: a retrospective cohort study. <em>Am J Kidney Dis</em>. 2022;79(5):626-634. doi:10.1053/j.ajkd.2021.07.013</li><li class="list-decimal ml-8">Jin X, Xu Q, Pu C, et al. Therapeutic efficacy of anti-CD19 CAR-T cells in a mouse model of systemic lupus erythematosus. <em>Cell Mol Immunol</em>. 2021;18(8):1896-1903. doi:10.1038/s41423-020-0472-1</li><li class="list-decimal ml-8">Müller F, Taubmann J, Bucci L, et al. CD19 CAR T-cell therapy in autoimmune disease - a case series with follow-up. <em>N Engl J Med</em>. 2024;390(8):687-700. doi:10.1056/NEJMoa2308917</li></ol><p class="pb-2"></p><p class="pb-2"></p><p class="pb-2"></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/navigating-healthcare-access-and-decision-making"><div class="w-full shadow-md 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overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f1dd6b59e85295091f77dfc0c25fdeb8a9856a93-4592x3448.jpg?fit=crop&auto=format" alt="Exterior of a hospital | Image Credit: Spiroview Inc. - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 27th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent">Facility Type Influences Antifibrotic Treatment Rates in Patients With IPF</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">A study in Japan found that antifibrotic treatment rates for patients with idiopathic pulmonary fibrosis (IPF) varied by medical facility, with higher treatment rates observed in referral hospitals than in general hospitals or clinics.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="Managed Care Cast" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 29th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent">Breaking the Cycle: The Importance of Early Intervention in Hidradenitis Suppurativa</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/3e5c760c89948ea062bc8055186b9134ab330099-3498x2332.jpg?fit=crop&auto=format" alt="Lonely patient | Image Credit: amazing studio - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent">Social Isolation Linked to Increased Mortality in Patients With COPD</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Social isolation significantly increases the risk of mortality in patients with chronic obstructive pulmonary disease (COPD), highlighting the need for targeted interventions to address this issue.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/453ff95d3edc29442e2af71658751e2f26adc78e-2500x2500.jpg?fit=crop&auto=format" alt="Managed Care Cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">July 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent">Insurance Insights: Dr Jason Shafrin Estimates DMD Insurance Value</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we're talking with the author of a study published in the July 2024 issue of The American Journal of Managed Care® that estimates the insurance value of novel Duchenne muscular dystrophy (DMD) treatment.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e8b89f6523b42f0e4eac2c396f686ac915160fbf-1200x738.jpg?fit=crop&auto=format" alt="Clinical trial results-Egor-stock.adobe.com.jpeg" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent">Progression-Free Survival in Relapsed Multiple Myeloma Extended With Ixazomib, Data Show</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Despite challenges such as high attrition rates and adverse events, the trial highlights the value of established therapies in improving outcomes, particularly in regions with limited access to chimeric antigen receptor T cells and bispecific antibodies.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/27d488950c5a56c184f46ca9ccce51baadec1a29-5607x3738.jpg?fit=crop&auto=format" alt="FDA headquarters | Image Credit: Grandbrothers - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent">Avutometinib With Defactinib for Recurrent KRAS Mutant LGSOC Completes Rolling New Drug Application</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/gillian-mcgovern">Gillian McGovern</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">If approved, the combination regimen would be the first FDA-approved treatment for adults with recurrent KRAS mutant low-grade serous ovarian cancer (LGSOC).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/f1dd6b59e85295091f77dfc0c25fdeb8a9856a93-4592x3448.jpg?fit=crop&auto=format" alt="Exterior of a hospital | Image Credit: Spiroview Inc. - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 27th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent">Facility Type Influences Antifibrotic Treatment Rates in Patients With IPF</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/facility-type-influences-antifibrotic-treatment-rates-in-patients-with-ipf?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">A study in Japan found that antifibrotic treatment rates for patients with idiopathic pulmonary fibrosis (IPF) varied by medical facility, with higher treatment rates observed in referral hospitals than in general hospitals or clinics.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="Managed Care Cast" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 29th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent">Breaking the Cycle: The Importance of Early Intervention in Hidradenitis Suppurativa</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/breaking-the-cycle-the-importance-of-early-intervention-in-hidradenitis-suppurativa?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/3e5c760c89948ea062bc8055186b9134ab330099-3498x2332.jpg?fit=crop&auto=format" alt="Lonely patient | Image Credit: amazing studio - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent">Social Isolation Linked to Increased Mortality in Patients With COPD</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/social-isolation-linked-to-increased-mortality-in-patients-with-copd?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Social isolation significantly increases the risk of mortality in patients with chronic obstructive pulmonary disease (COPD), highlighting the need for targeted interventions to address this issue.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/453ff95d3edc29442e2af71658751e2f26adc78e-2500x2500.jpg?fit=crop&auto=format" alt="Managed Care Cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">July 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent">Insurance Insights: Dr Jason Shafrin Estimates DMD Insurance Value</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/insurance-insights-dr-jason-shafrin-estimates-dmd-insurance-value?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we're talking with the author of a study published in the July 2024 issue of The American Journal of Managed Care® that estimates the insurance value of novel Duchenne muscular dystrophy (DMD) treatment.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e8b89f6523b42f0e4eac2c396f686ac915160fbf-1200x738.jpg?fit=crop&auto=format" alt="Clinical trial results-Egor-stock.adobe.com.jpeg" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent">Progression-Free Survival in Relapsed Multiple Myeloma Extended With Ixazomib, Data Show</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/progression-free-survival-in-relapsed-multiple-myeloma-extended-with-consolidation-and-maintenance-therapy-with-ixazomib?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Despite challenges such as high attrition rates and adverse events, the trial highlights the value of established therapies in improving outcomes, particularly in regions with limited access to chimeric antigen receptor T cells and bispecific antibodies.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/27d488950c5a56c184f46ca9ccce51baadec1a29-5607x3738.jpg?fit=crop&auto=format" alt="FDA headquarters | Image Credit: Grandbrothers - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 26th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent">Avutometinib With Defactinib for Recurrent KRAS Mutant LGSOC Completes Rolling New Drug Application</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/gillian-mcgovern">Gillian McGovern</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/avutometinib-with-defactinib-for-recurrent-kras-mutant-lgsoc-completes-rolling-new-drug-application?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">If approved, the combination regimen would be the first FDA-approved treatment for adults with recurrent KRAS mutant low-grade serous ovarian cancer (LGSOC).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Review: CAR T Cells Could Transform Pediatric SLE Therapy","datePublished":"2024-09-04T21:30:00.465Z","dateModified":"2024-09-04T20:59:24Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/86002120662bc086c89a9494427508ac7a4ceea2-1200x724.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/review-car-t-cells-could-transform-pediatric-sle-therapy"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"gene therapy,cell therapy,sle","articleBody":"A novel cell therapy that first emerged as a treatment for hematological malignancies may be an effective treatment option for children with systemic lupus erythematosus (SLE), a new report indicates.\n\nA review article in Pediatric Rheumatology suggests chimeric antigen receptor (CAR) T-cell therapy may address some of the shortcomings of existing SLE therapies, thereby improving long-term patient outcomes.1\n\n\n\nCorresponding author Ivana Stojkic, MD, of Nationwide Children’s Hospital, and colleagues, explained that a diagnosis with SLE in childhood is associated with increased morbidity and mortality compared with adult cases. One of the most dangerous complications, they noted, is lupus nephritis (LN).\n\n“Lupus nephritis in particular carries significant morbidity and has an increased prevalence and severity in children and adolescents compared to adults,” they explained.\n\nThough the armamentarium for treating SLE has increased in recent years, the authors said survival rates have “plateaued.” Nearly one-quarter (22%) of children with SLE who develop end-stage kidney disease as a result of LN will die within 5 years, they said.\n\nA 2022 report that compared outcomes of children on dialysis due to LN to those of children on dialysis for nonlupus glomerular disease found children with LN had worse outcomes, were more likely to be hospitalized during their first year on dialysis, and were less likely to receive a kidney transplant in their first 3 years on dialysis.2\n\nChildren with SLE are typically treated with long-term high-dose glucocorticoids and immunosuppression, which can themselves lead to adverse effects and infections.\n\n“Therefore, there remains a significant unmet need for new therapies that can improve disease control and reduce glucocorticoid and other toxic medication exposure for these patients,” Stojkic and colleagues said.1\n\nRecent attention has focused on the role of B-cell dysregulation and autoantibody production in the pathogenesis of the disease. Two B-cell targeting therapies—rituximab (Rituxan) and belimumab (Benlysta)—have shown efficacy in patients with SLE, but Stojkic and colleagues said many patients do not achieve an adequate response with those therapies. One reason, they said, could be incomplete B-cell depletion or an inability to target long-lived antibody-producing plasma cells.\n\nCAR T-cell therapy involves collecting T cells, re-engineering them to target a specific antigen, and then infusing them back into the patient. Though the first wave of CAR T-cell therapies have focused on cancers like B-cell non-Hodgkin lymphoma and multiple myeloma, investigators have begun to consider a wider array of indications for the therapies.\n\nIn a murine model of SLE, anti-CD19 CAR T cells were found to spark sustained B-cell depletion leading to therapeutic benefits.3 Furthermore, the authors of that study also found the therapy showed preventative effects when given to mice before the onset of disease.\n\nInvestigation of CAR T cells in human subjects with SLE has been limited, the authors said, but the early data are promising. Earlier this year, investigators studying the impact of CAR T-cell infusion in patients with 3 autoimmune diseases, including SLE, published results showing the therapy to be feasible, safe, and effective.4 That study included 5 young adults (ages 18-24 years) with SLE, and found the therapy led to sustained depletion of circulating B cells, along with control of LN and a decrease in SLE Disease Activity Index scores.\n\nOther reports have found similarly positive results. In addition, Stojkic and colleagues said, the patients with SLE who have received CAR T-cell therapies have tended to have less severe side effects, such as cytokine release syndrome (CRS).1\n\n“The safety profile to date for the SLE population is more favorable compared to the oncology population due to a smaller target T cell population, and therefore a lower underlying risk of CRS,” they wrote.\n\nThe investigators said more research will be needed to better understand the therapy’s long-term safety and efficacy in children with SLE. They said controlled clinical trials are warranted, but said those trials should include both adult and pediatric patients with SLE, given the potentially life-changing impacts of successfully treating SLE in younger patients.\n\nReferences\n\nStojkic I, Harper L, Coss S, et al. CAR T cell therapy for refractory pediatric systemic lupus erythematosus: a new era of hope? Pediatr Rheumatol Online J. 2024;22(1):72. doi:10.1186/s12969-024-00990-4\n\nWasik H, Chadha V, Galbiati S, Warady B, Atkinson M. Dialysis outcomes for children with lupus nephritis compared to children with other forms of nephritis: a retrospective cohort study. Am J Kidney Dis. 2022;79(5):626-634. doi:10.1053/j.ajkd.2021.07.013\n\nJin X, Xu Q, Pu C, et al. Therapeutic efficacy of anti-CD19 CAR-T cells in a mouse model of systemic lupus erythematosus. Cell Mol Immunol. 2021;18(8):1896-1903. doi:10.1038/s41423-020-0472-1\n\nMüller F, Taubmann J, Bucci L, et al. CD19 CAR T-cell therapy in autoimmune disease - a case series with follow-up. N Engl J Med. 2024;390(8):687-700. doi:10.1056/NEJMoa2308917\n\n\n\n\n\n","description":"Early data suggest chimeric antigen receptor (CAR) T-cell therapy can achieve meaningful long-term results.","author":[{"@type":"Person","name":"Jared Kaltwasser"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] py-12 pl-auto"><div class="xxl:w-[75%] w-[90%] ml-auto"><div><span 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The researchers noted that many untreated patients had mild IPF, indicating a lack of proactive treatment.","_key":"1786ff5389d00"}]},{"_type":"block","style":"normal","_key":"bd544b033879","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ba73852589c10"}]},{"_key":"66c63c57ca1a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Conversely, some cases present challenges for initiating antifibrotic therapy, and poor PS can hinder treatment continuation; starting therapy in patients with preserved PS is preferable. Building on past research, the researchers surveyed general practitioners and respiratory physicians in Japan to determine the proportion of untreated patients with IPF and factors associated with nonintervention.","_key":"5579653999780"}],"_type":"block","style":"normal"},{"asset":{"_type":"reference","_ref":"image-f1dd6b59e85295091f77dfc0c25fdeb8a9856a93-4592x3448-jpg"},"disableTextWrap":false,"disableLightBox":true,"_type":"figure","imgcaption":[{"_key":"308532b7e3b2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Antifibrotic treatment rates for patients with idiopathic pulmonary fibrosis (IPF) varied by medical facility, with higher treatment rates observed in referral hospitals than in general hospitals or clinics. | Image Credit: Spiroview Inc. - stock.adobe.com","_key":"2b83b0b08ece"}],"_type":"block","style":"normal"}],"widthP":40,"alignment":"right","alt":"Exterior of a hospital | Image Credit: Spiroview Inc. - stock.adobe.com","_key":"2939b480fd65"},{"markDefs":[],"children":[{"marks":[],"text":"The study was conducted at 23 medical facilities (9 clinics, 12 general hospitals, 1 university hospital, and 1 specialized respiratory hospital) in Yamaguchi, Japan, from December 2019 to October 2020. The researchers included patients diagnosed with IPF at the study facility.","_key":"92476cdfcdbf0","_type":"span"}],"_type":"block","style":"normal","_key":"218de00e81b4"},{"_type":"block","style":"normal","_key":"e0ebc73c01cc","markDefs":[],"children":[{"text":"","_key":"5c74ca26fc0a0","_type":"span","marks":[]}]},{"style":"normal","_key":"7e25fab5b342","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Both physicians and patients conducted the surveys. Patients completed a 3-item questionnaire on PS, cough symptom severity, and the modified Medical Research Council (mMRC) scale. In contrast, physicians recorded patients' demographic data, clinical characteristics, and IPF diagnoses. They also recorded clinical examination data, treatment details, when treatment started, and why; for those who did not receive treatment, the physicians recorded the reasons why.","_key":"32a68fa996790"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8a631a22d4fb0"}],"_type":"block","style":"normal","_key":"5df46ffb0cc2"},{"_key":"24cdddf66e01","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Physicians in the specialized respiratory and university hospitals also asked about the time from diagnosis at other facilities to referral, pulmonary function test (PFT) results, and Krebs von den Lungen 6 (KL-6) and surfactant protein D (Sp-D) values at the initial visit. ","_key":"777ac23244e30"}],"_type":"block","style":"normal"},{"style":"normal","_key":"8d63c4c5ab36","markDefs":[],"children":[{"text":"","_key":"7c39b5f03be4","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The researchers performed a principal component analysis (PCA) using 15 clinical variables, including age, sex, medical facility, body mass index (BMI), specialized tests, and symptom severity. In the PCA plots, the researchers evaluated the distribution of clinical variables vs antifibrotic treatment.","_key":"2ecfffb092c6"}],"_type":"block","style":"normal","_key":"ed023c3455f7"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"e78245645f0a0"}],"_type":"block","style":"normal","_key":"1b5aff0d650c"},{"markDefs":[],"children":[{"marks":[],"text":"The researchers enrolled 518 patients with interstitial lung disease (ILD) in the study, 207 of whom were diagnosed with IPF. Among these 207 patients, 168 had a good PS, or a PS of 2 or less, which could indicate their treatment eligibility. Their mean (SD) age was 76.5 (8.2), and most (72.6%) were male. Also, 125 (74%) received treatment at a general hospital, 29 (17%) at either a specialized respiratory or a university hospital, and 14 (8%) at a clinic.","_key":"72be55df72210","_type":"span"}],"_type":"block","style":"normal","_key":"5f9e9f8aea0d"},{"markDefs":[],"children":[{"_key":"d2dda4277fa10","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"8a0422349fc3"},{"children":[{"_type":"span","marks":[],"text":"Of those with IPF, 39 (22.6%) received an antifibrotic drug. The PCA determined that the rate of antifibrotic treatment was significantly higher in referral hospitals than in clinics or general hospitals. Based on physicians’ questionnaires, most did not prescribe antifibrotic drugs due to mild symptoms, imaging findings, or oxygenation, with no differences between facilities. 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Therefore, symptom severity is a relevant factor for therapeutic intervention decisions in general hospitals. Conversely, treatment rates in referral hospitals were not associated with PS, mMRC score, or LTOT use; symptom severity is not considered when deciding on therapeutic intervention in this setting.","_key":"3bea81611d952"}],"_type":"block","style":"normal","_key":"6d62900c1858"},{"_type":"block","style":"normal","_key":"c6d313d6b853","markDefs":[],"children":[{"_key":"2143012e56060","_type":"span","marks":[],"text":""}]},{"children":[{"_type":"span","marks":[],"text":"The researchers acknowledged their limitations, one being that they conducted their study in a rural part of Japan rather than an urban area. Therefore, it cannot be considered an overall assessment of the country. Similarly, because it only analyzed patients within Japan, the findings may not be generalizable to other populations. 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You can connect with Brooke on ","_key":"bb68b5e8ee83","_type":"span"},{"marks":["80a1c1a9d7cd"],"text":"LinkedIn","_key":"4bb222fe2840","_type":"span"},{"_type":"span","marks":[],"text":".","_key":"c87621477700"}]}],"url":{"current":"brooke-mccormick","_type":"slug"},"firstName":"Brooke"}],"published":"2024-11-26T15:30:03.778Z","_createdAt":"2024-11-26T13:30:00Z","documentGroup":null,"body":[{"children":[{"marks":[],"text":"Social isolation is independently associated with increased mortality in patients with ","_key":"53fe663f11f00","_type":"span"},{"text":"chronic obstructive pulmonary disease (COPD)","_key":"3ba47d3088d2","_type":"span","marks":["f8f5eaabc4e3"]},{"_key":"e97a2cdd4046","_type":"span","marks":[],"text":", according to a research letter published in "},{"_type":"span","marks":["7924afdbf132","em"],"text":"JAMA Internal Medicine","_key":"53fe663f11f01"},{"_type":"span","marks":["em"],"text":".","_key":"53fe663f11f02"},{"_type":"span","marks":["superscript"],"text":"1","_key":"a660340cb1d0"}],"_type":"block","style":"normal","_key":"9ec207c156c3","markDefs":[{"_key":"7924afdbf132","nofollow":true,"blank":true,"_type":"link","href":"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2825360?resultClick=1"},{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/compendium/copd","_key":"f8f5eaabc4e3"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"5b67470bd7900","_type":"span"}],"_type":"block","style":"normal","_key":"87e51d0a4c49"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Social isolation, an objective state of limited to no social contact, has been linked to poor health outcomes and mortality among those aged 65 or older. Also, about 1 in 5 people with COPD experience social isolation, which is about twice as much as older adults overall. The researchers attributed this increase in social isolation to disease features, like breathlessness and reduced physical function.","_key":"f3dab0502db60"}],"_type":"block","style":"normal","_key":"aaccb6b585f1"},{"_key":"0a7af4acb511","markDefs":[],"children":[{"text":"","_key":"4751709591650","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"children":[{"marks":[],"text":"However, the association of social isolation in COPD with downstream outcomes, like mortality, has not been examined. Consequently, the researchers investigated the association between social isolation and all-cause mortality in a nationally representative cohort of US adults with COPD.","_key":"1b0ea77b76fd0","_type":"span"}],"_type":"block","style":"normal","_key":"d76bb7775fab","markDefs":[]},{"disableLightBox":true,"_key":"25f507c99ce3","alignment":"right","widthP":40,"disableTextWrap":false,"_type":"figure","imgcaption":[{"_key":"e0e2770b4a9e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Social isolation significantly increases the risk of mortality in patients with chronic obstructive pulmonary disease (COPD). | Image Credit: amazing studio - stock.adobe.com","_key":"edc92c349891"}],"_type":"block","style":"normal"}],"alt":"Lonely patient | Image Credit: amazing studio - stock.adobe.com","asset":{"_ref":"image-3e5c760c89948ea062bc8055186b9134ab330099-3498x2332-jpg","_type":"reference"}},{"markDefs":[{"_key":"df3fe86ca57f","nofollow":true,"blank":true,"_type":"link","href":"https://academic.oup.com/ije/article-abstract/43/2/576/2901743?redirectedFrom=fulltext"}],"children":[{"_type":"span","marks":[],"text":"They ","_key":"3a3828d146090"},{"text":"used","_key":"c531133b6f8b","_type":"span","marks":["df3fe86ca57f"]},{"_type":"span","marks":[],"text":" data from the Health and Retirement Survey (HRS), focusing on adults aged 51 or older, with the dataset spanning 2006 to 2022.","_key":"0ead5596db24"},{"marks":["superscript"],"text":"2","_key":"429e0d223947","_type":"span"},{"_key":"659d5af1acda","_type":"span","marks":[],"text":" Additionally, the researchers used a previously published social isolation scale, which included metrics like being unmarried, lacking community participation, living alone, and having no social contact with children, family, or friends."},{"marks":["superscript"],"text":"1","_key":"c146d2e8dfa9","_type":"span"}],"_type":"block","style":"normal","_key":"ff92fda7e0e0"},{"_key":"2c302c9201a4","markDefs":[],"children":[{"text":"","_key":"7108976c8b440","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Individuals received 1 point for each applicable metric, with scores ranging from 0 to 6. Those with 3 points or more were classified as experiencing social isolation. The researchers noted that participants were included at the first available wave in which they self-reported COPD and answered at least 3 questions related to social isolation.","_key":"774bce287f390"}],"_type":"block","style":"normal","_key":"36b241a75d00"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"fe2f81665c4c0","_type":"span"}],"_type":"block","style":"normal","_key":"b08eb8c285c6"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"All-cause mortality was determined using HRS date-of-death measures. Cox proportional hazard models were then used to determine the association between social isolation and all-cause mortality, adjusting for age, race, sex, and ethnicity, which have previously been associated with social isolation.","_key":"df4927f8fef80"}],"_type":"block","style":"normal","_key":"8ccf59deb9bb"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"4ade442bd8d00"}],"_type":"block","style":"normal","_key":"dd06cf11b8c2"},{"style":"normal","_key":"06ad69063af8","markDefs":[],"children":[{"text":"The study population consisted of 1241 participants, with a mean (SD) age of 68.4 (9.8) years; the majority was female (59.3%). Of these participants, 293 (23.6%) reported experiencing social isolation. Additionally, 539 participants (43.4%) died after a median follow-up of 4.4 years (range, 0.1-14.6 years).","_key":"48351ba598330","_type":"span","marks":[]}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"","_key":"894f2dfd41e70"}],"_type":"block","style":"normal","_key":"56dae2dd0f40","markDefs":[]},{"markDefs":[],"children":[{"text":"Those with COPD and social isolation were at an increased risk of death (unadjusted HR, 1.35; 95% CI, 1.08-169; adjusted HR, 1.35; 95% CI, 1.04-1.75) than those without social isolation. Therefore, median survival time was lower among socially isolated participants (7.0 years; 95% CI, 5.8-8.2) vs those not socially isolated (9.1 years; 95% CI, 8.3-10.4). Similarly, the 5-year survival rate among socially isolated participants (62.9%; 95% CI, 56.6-68.6) was lower than that of those not socially isolated (71.1%; 95% CI, 67.7-74.1).","_key":"9bfcb9e368860","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"9f7adc54e414"},{"_type":"block","style":"normal","_key":"b9a96716f5b5","markDefs":[],"children":[{"text":"","_key":"8262dc6900c20","_type":"span","marks":[]}]},{"_key":"b625550b3317","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“We hypothesize that social isolation may increase mortality risk in COPD by limiting access to necessary support and resources for managing debilitating symptoms such as breathlessness, functional limitations, and complex medical regimens, particularly after hospital or intensive care unit stays,” the authors wrote.","_key":"4046d8b0951f0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"0d7d57967c140","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"80b317da5ebe"},{"_type":"block","style":"normal","_key":"8a738e31fc75","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Consequently, the researchers emphasized that addressing social isolation through expanded interdisciplinary efforts could improve well-being and provide resources to help proactively plan for health crises. Potential interventions include support groups, group-based pulmonary rehabilitation, and behavioral activation to promote self-efficacy.","_key":"0694c4963aa4"}]},{"_key":"434fde22a961","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"4077d9e200800"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Lastly, the researchers acknowledged their limitations, one being that patients self-reported COPD diagnoses. This could capture other less common chronic lung diseases, like interstitial lung disease. 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