New developments in the treatment of certain refractory inflammatory myositis

German clinicians report a case of antisynthetase syndrome (ASyS) treated with several biotherapies:

  • the patient, aged 45, had ASyS with signs of joint, muscle (myositis) and respiratory (interstitial lung disease) disease, with the presence of autoantibodies directed against the Jo-1 antigen,
  • an initial treatment with CAR-T cells directed against CD19 lymphocytes resulted in remission for 9 months,
  • following a relapse, The patient then received the same cell therapy, this time with a non-response to the treatment.
  • after a wait-and-see treatment with anti-CD38 (daratumumab), the patient was able to receive a new type of CART-T cell called BCMA on a compassionate basis, this time with a favourable and lasting response.

This case illustrates the challenges of reinjecting CART-T cells, but also the progress made by innovative biotherapies in refractory forms of autoimmune diseases.

 

BCMA CAR T cells in a patient with relapsing idiopathic inflammatory myositis after initial and repeat therapy with CD19 CAR T cells. Müller F, Wirsching A, Hagen M, et al. Nat Med. 2025 Apr