From myth to bedside: a scoping review of the applications of the chimeric antigen receptor in rheumatology.

Chimeric antigen receptor (CAR) based therapies are promising in systemic autoimmune rheumatic disease (SARD) according to recent case reports. To establish the state of the art of the applications of CAR therapies in rheumatology, PubMed, EMBASE, Lilacs, as well as clinical trial registries were searched. Any type of original article that reported the use of these therapies in patients with SARD was included. Forty-eight studies were included from databases. Ninety-five ongoing trials were included from clinical trials registries. The most used type of CAR was a CAR-T against CD19, showing good preliminary results. Other targets used were BCMA, PD-1, a modified HLA and citrullinated peptides among others. The use of other cell types such as natural killer and regulatory T cells was also found. CAR-based therapies in rheumatology are in an early stage of development but with promising results. There has been a notable growth in human patients treated with this intervention in the last 2 years. This and other innovative designs will offer a wide range of new therapeutic possibilities. Results of ongoing clinical trials are needed to establish their efficacy and safety in SARD.