26 Combinations of biologics

Clinical experiences have now been published including small numbers of patients with a variety of autoimmune diseases including systemic lupus erythematosus (SLE), and for the most part these reports have been encouraging: along with the depletion of B cells, autoantibody titres decreased, and rapid and complete clinical responses were seen in many patients. 1 2B-cell reconstitution took place as expected, and vaccine responses were restored, but autoantibodies did not re-emerge, and clinical relapses did not occur in the lupus patients reported to date; in some patients a treatment-free remission for over two years has now been documented and CAR-T cell therapy was well-tolerated in these patients.The main questions that now must be addressed are:. Is the abolition of autoreactive B-cell activity permanent?. If so, is it sufficient for patients with SLE to remain free of disease? .If so, can the necessary degree of B-cell depletion be achieved by other means? .What are the true risks and possible side effects of CAR-T cell therapy in patients with autoimmune diseases? .What role does 'conditioning chemotherapy' have in CAR-T cell therapy? .How should patients be selected for CAR-T cell therapy?