Autoimmune diseases refer to a common category of diseases caused by the immune system reacting to self-antigens, leading to tissue damage. Autoimmune diseases encompass a wide variety of conditions, such as systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, inflammatory myopathies, ANCA-associated vasculitis. Current treatments for autoimmune diseases include glucocorticoid, immunosuppressants, and biologics. B cell-driven humoral immune abnormalities are a central pathogenic mechanism in many autoimmune diseases. When autoreactive B cells are excessively activated, they produce large amounts of autoantibodies and immune complexes. These antibodies and immune complexes can cause damage to various tissues and organs, leading to the development of multiple autoimmune diseases. Therefore, targeting B cells to treat autoimmune diseases is an attractive therapeutic strategy. Clinical studies are exploring the use of CD19-targeting CAR-T cells for the treatment of autoimmune diseases, and their therapeutic efficacy has been demonstrated. In this study, we investigate the safety and efficacy of universal CD19-targeting CAR T cells in the treatment of autoimmune diseases.
Age between 18-80 years (inclusive), male or female.
>40kg.
Diagnosed with refractory autoimmune disease, defined as: Ineffectiveness of conventional treatment for more than 6 months, or Disease activity recurrence after remission. Definition of conventional treatment: Use of glucocorticoids and any of the following immunosuppressants or biologics: cyclophosphamide, azathioprine, mycophenolate mofetil, methotrexate, leflunomide, tacrolimus, cyclosporine, rituximab, belimumab, telitacicept, etc.
Currently receiving one or more standard therapies at a stable dose, including glucocorticoids, antimalarials, immunosuppressants, or biologics. If the subject is receiving glucocorticoids, the following conditions must be met: During screening and the screening period, the maximum dose of glucocorticoids is 30 mg/day prednisone (or an equivalent dose). The glucocorticoid dose must remain stable for ≥7 days before screening, and during the screening period, the dose adjustment must not exceed >5 mg/day prednisone (or an equivalent dose). If the subject is receiving antimalarials and/or conventional immunosuppressants: The treatment must have started ≥12 weeks before screening. The medication dose must remain stable for ≥8 weeks before screening and throughout the screening period. Before cell infusion, other immunosuppressants (excluding hydroxychloroquine), including belimumab, telitacicept, CD20 monoclonal antibodies, or other biologic immunosuppressants, must be discontinued for at least 5 half-lives.
Subjects with a history of alcohol abuse or substance abuse within the past 24 weeks;
Subjects with other psychiatric disorders such as schizophrenia or major depressive disorder;
Subjects with a history of malignancies other than B-cell lymphoma;
Subjects with overlapping diseases that affect the assessment of disease activity;
Single group
anti-CD19 CAR-T cells
Biological/VaccineUWD-CD19
Evaluate the safety of UWD-CD19 cell injection in the treatment of refractory autoimmune diseases.
In this study, adverse events (AEs) are defined as any adverse medical events occurring from the initiation of lymphodepleting chemotherapy to 12 months after the completion of QH103 cell infusion. The incidence, duration, severity, and management of all adverse events occurring after the participants' enrollment will be recorded and evaluated.Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) will be graded according to the American Society for Transplantation and Cellular Therapy (ASTCT) criteria. Graft-versus-host disease (GVHD) will be graded based on the criteria defined by the Mount Sinai Acute GVHD International Consortium. Other AEs will be graded according to the Common Terminology Criteria for Adverse Events (CTCAE, v5.0)
Maximum tolerated dose of UWD-CD19 cells
Dose-limiting toxicity after cell infusion
Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2000) score
The change from baseline in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2000) score at 90 days, 180 days, 360 days.
Low Lupus Disease Activity State(LLDAS)
SLE patients who met Low Lupus Disease Activity State(LLDAS)
Systemic Sclerosis Combined Response Index (CRISS) response
Patients achieve Systemic Sclerosis Combined Response Index (CRISS) response. A responder meets all of the following criteria; otherwise, they are classified as a non-responder. a. Improvement in at least two aspects (≥ 5% increase in ppFVC and/or ≥ 25% decrease in mRSS, HAQ-DI, PtGA, or PhGA); b. Worsening in no more than one aspect (≥ 5% decrease in ppFVC and/or ≥ 25% increase in mRSS, HAQ-DI, PtGA, or PhGA); c. No significant new SSc-related manifestations.
Modified Rodnan Skin Score (mRSS)
The changes from baseline in the modified Rodnan Skin Score (mRSS).
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