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Credit: Towfiqu barbhuiya from Pexels<\/p>\n
Research led by Friedrich-Alexander-Universit\u00e4t Erlangen\u2013N\u00fcrnberg provides evidence that teclistamab may offer therapeutic benefit for patients with severe forms of treatment-resistant autoimmune diseases.<\/p>\n
Autoimmune conditions can defy conventional immunosuppressive treatments, leaving patients with persistent inflammation and few options. Previous therapies such as B-cell depletion with rituximab often fail to maintain remission. Agents that more precisely eliminate autoreactive immune cells have been sought to achieve control without long-term toxicity.<\/p>\n
In a letter to the editor, “BCMA T-Cell Engager Therapy in Patients with Refractory Autoimmune Disease,” published<\/a> in the New England Journal of Medicine correspondence section, investigators administered teclistamab under compassionate use to evaluate its safety and efficacy.<\/p>\n A total of 10 participants with six autoimmune diseases<\/a> (systemic sclerosis, primary Sj\u00f6gren’s syndrome, idiopathic inflammatory myositis, rheumatoid arthritis<\/a>, Graves disease, and IgG4-related disease) received treatment. The median age was 55 years, and 60% were women. Nine participants had previously received B-cell depletion with rituximab.<\/p>\n Rapid B-cell depletion followed administration, with a median B-cell aplasia duration of 157 days. Decreases in free light chains and immunoglobulin levels indicated marked plasma-cell depletion.<\/p>\n Serologic responses included lowered autoantibody titers and seroconversion across multiple antibody classes. In IgG4-related disease, inflammatory markers normalized with symptomatic improvement. Pulmonary function improved in most patients with interstitial lung disease<\/a>, and imaging demonstrated reduced orbital inflammation in Graves disease.<\/p>\n Clinical benefit was observed in nine patients and six achieved drug-free remission lasting up to 15 months after a single course. Median response duration across the cohort was 10 months.<\/p>\n Cytokine release syndrome appeared in eight of 10 patients, all low grade and responsive to a single dose of tocilizumab. No neurotoxicity occurred. Upper respiratory infections were frequent but mild; bacterial infections required antibiotics in two cases. All patients developed hypogammaglobulinemia managed with immune globulin infusions.<\/p>\n Investigators concluded that teclistamab showed sustained efficacy across diverse refractory autoimmune disorders, with manageable adverse effects primarily limited to mild cytokine release and infection risk.<\/p>\n The findings suggest that BCMA-targeted T-cell engagement could represent a viable strategy for immune rebalancing in conditions unresponsive to conventional therapy, warranting further clinical trials.<\/p>\n \n Written for you by our author Justin Jackson<\/a>, edited by Sadie Harley<\/a>, and fact-checked and reviewed by Robert Egan<\/a>\u2014this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive.
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