Mivocabtagene autoleucel, an autologous CD19-directed CAR-T cell therapy, shows promise in treating refractory rheumatoid arthritis, according to findings presented at EULAR 2026 in London.
Fredrik Albach from Charité Universitätsmedizin Berlin presented Phase I results from the COMPARE trial. Six patients with ACPA-positive, treatment-refractory rheumatoid arthritis were treated.
Treatment was well tolerated with mild-to-moderate cytokine release syndrome and no neurotoxicity. CAR-T cells expanded rapidly, peaking within three weeks. B cells were effectively depleted in blood and tissues.
Autoantibodies decreased by a median of over 90%, with sustained seroconversion to normal ACPA in four patients. Disease activity dropped by a median 49% in DAS28-CRP scores. Half achieved sustained remission without ongoing immunosuppression.
In a separate study on refractory systemic sclerosis, dual-target CAR-T therapy in 11 patients showed rapid B-cell aplasia and significant skin thickness score improvements, with 73% reaching low disease activity. Lung function stabilized or improved in most patients. No flares occurred during follow-up.
Yajing Zhang from GoBroad Boren Hospital in Beijing stated this approach offers "true curative potential" and paves the way for Phase II trials.