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Chimeric antigen receptor T-cell (CAR-T) therapy is emerging as a novel treatment for systemic autoimmune rheumatic diseases. To date, CAR-T therapy in rheumatology has been reported only in case studies and conference abstracts, but clinical trial results are forthcoming. Current evidence indicates a rapid and highly effective therapeutic response with a favourable side effect profile, suggesting that CD19 CAR-T therapy could be beneficially established for these conditions. Initially, CAR-T therapy appears relevant for a select group of severe, treatment-resistant rheumatic diseases.