Researchers from Germany’s University of Erlangen-Nuremberg have unveiled promising clinical data on the use of bispecific T cell engagers (BiTes) in combating B-cell mediated autoimmune diseases, such as rheumatoid arthritis (RA). The study, titled “Bispecific T cell engager therapy for refractory rheumatoid arthritis,” published in Nature Medicine in December 2023, suggests that Amgen’s CD19-CD3-targeted BiTE, blinatumomab (Blincyto), could be a game-changer in RA treatment.
The small study involved six RA patients with multi-drug resistance who were administered blinatumomab through a compassionate use process. The treatment led to a significant depletion of B-cells, akin to that observed in CD19-targeted chimeric antigen receptor (CAR) T-cell therapies used for autoimmune diseases. Each patient received two five-day infusions of blinatumomab, resulting in a rapid decline in RA clinical disease activity, with all patients achieving clinical remission three months post-treatment.
The study found that blinatumomab, given at a lower dosage and over a shorter period than typically used in cancer treatment, was well-tolerated by all patients. There were no serious adverse events, and mild reactions were confined to the first week of therapy. Ultrasound and FAPI-PET-CT scans revealed improved synovitis, and a reduction in autoantibodies was also observed.
The researchers concluded that the data supports the potential use of CD19xCD3 BiTEs in treating refractory RA and possibly other B-cell mediated autoimmune diseases. They recommend further exploration into the role of BCMA-directed BiTEs for autoimmune conditions. Interestingly, Amgen has not yet initiated any trials to assess Blincyto in autoimmune diseases, as per the Clinicaltrials.gov website.- Flcube.com
