To define the current evidence for CAR-based cellular therapy in relapsed or refractory systemic lupus erythematosus (SLE) by resolving overlapping reports and synthesising patient-level phenotype, safety and efficacy data.
Approach:
Systematic Review: Conducted a systematic review with overlap-controlled patient-level synthesis of CAR-based cellular therapy in relapsed or refractory SLE, searching PubMed, Embase, and Web of Science for relevant reports.
Key Findings:
Twenty-one independent study units comprising 114 patients were included, predominantly female (87.7%) with a median age of 32 years.
Clinical response was documented in 45 of 45 evaluable patients, with various response rates for specific endpoints.
Cytokine release syndrome was usually low grade, and severe inflammatory toxicities occurred in selected cases.
Interpretation:
Current evidence for CAR-based cellular therapy in refractory SLE is early and uncontrolled.
Limitations:
Sparse exactly evaluable denominators and incomplete reporting of outcomes.
Publication bias and selective outcome reporting.
Short follow-up periods limit definitive conclusions.
Conclusion:
Current evidence remains early and incompletely reported, necessitating standardised prospective studies with harmonised endpoints.
