Immunotherapy for Those with Autoimmune Disease

Medicines and treatments for people with autoimmune diseases have vastly advanced over the past decades. However, one of the main challenges is finding therapies that effectively prevent disease progression and flare-ups. Immunotherapy includes a collection of medical approaches that work by exploiting the immune system’s properties and activities to treat and manage various diseases.

What is Immunotherapy?

Immunotherapy strategies work by modifying, stimulating, or slowing down the body’s immune system using antibodies, vaccines, or other substances. Many of these substances are produced from living organisms and are called biological therapies, or, more commonly, biologics.

What Types of Immunotherapy Are Used in Autoimmune Diseases?

In diseases such as cancer, immunotherapy treatments typically activate the immune system and its pathways to destroy malignant cells. In autoimmunity, immunotherapy treatments restrain or block immune factors and pathways and stop the immune system from attacking and harming the body.

Which Immunotherapy Approaches Work Best for Autoimmune Diseases?

The most suitable immunotherapeutic approaches should be selected after thoroughly assessing each autoimmune disease case and a patient’s overall health. When used in the right situation, immunotherapy can clear even the most severe flare-ups and radically improve patients’ lives.

The American College of Rheumatology offers essential information for health professionals on biologics and other drugs for people with rheumatic diseases. For example, the monoclonal antibody, adalimumab (Humira®), blocks the activity of TNF-alpha and treats rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis in adults, and juvenile idiopathic arthritis in children. The monoclonal antibody, certolizumab (Cimzia®), also a TNF alpha blocker, helps to treat Crohn’s disease (6). 

In 2022, the monoclonal humanized antibody teplizumab (Tzield®) was approved by the Food and Drug Administration (FDA) to treat advanced type 1 diabetes in children aged eight and above, as well as adults. Teplizumab is safe and effective and can be infused for 12 days, with no requirement for long-term administration (7, 8)

David Hafler, MD, a human immunologist and an expert in diseases of the nervous system disorders at Yale School of Medicine, routinely uses immunotherapy in patients with multiple sclerosis (MS). “In the 1970s, there were no helpful therapies for MS, but now we can successfully treat the disease with immunotherapy. Yet, many people don’t know this,” says Hafler.

Hafler discusses that B-cell depletion is a useful option for MS. “B-cell depletion drugs have a 98% success rate in slowing down the disease process,” he says. “And although it’ll take us 20 to 30 years to know whether the treatment can stop the progressive form of the disease, B-cell depletion continues to improve people’s lives, especially when we start treating early,” he adds.

Immunotherapy treatments work well for other autoimmune diseases, too. “Interleukin (IL) -17 inhibitors are incredibly effective for psoriasis,” he says.

Cameron Coury, MD, a board-certified dermatologist in Richardson, TX, who regularly treats patients with psoriasis, also highlights the benefits of IL-17 inhibitors. “IL-17 inhibitors affect the immune system in a narrow way, re-balancing the arm of the immune system that is overactive, but leaving the remainder relatively untouched,” says Coury. “These medications are especially effective for psoriasis and can work quickly to clear even some of the most severe disease cases,” she adds.

CAR T-cell therapy stands out as a promising personalized treatment approach for autoimmune rheumatic diseases, including lupus, rheumatoid arthritis, Sjögren’s syndrome, and ankylosing spondylitis. “Research on CAR T-cell therapy for patients with lupus has been encouraging, but this disease is especially complex, so we’ll have to wait for more results,” adds Hafler.

What Are the Side Effects of Immunotherapy for Autoimmune Diseases?

Because of its ability to suppress the immune system, immunotherapy can cause adverse effects that vary depending on the disease. Patients who are prescribed immunotherapy drugs should be carefully monitored because infection is one of the potential complications (9).

Hafler indicates that the benefits of B-cell depletion therapy for MS outweigh the risk of undesired effects. “In young patients, we see a slight increase in infection rates, including urinary tract infections. However, over years of treatment this is relatively benign,” he says.

Coury mentions that IL-17 inhibitors also cause fewer adverse effects because they target the immune system in a focused way. “Many of my patients are very happy on medications that inhibit IL-17. They work quickly to clear inflammation in patients with psoriasis and joint inflammation/arthritis – both skin and joints improve quickly when using IL-17 inhibitors,” Coury says. “And these medications are also very tolerable with minimal side effects in most patients,” she adds.

How Can People Learn More About Immunotherapy for Autoimmune Diseases?

Patients who’d like to consider immunotherapy should talk to their doctor or immune disease specialist about options for their specific autoimmune disease or comorbidities.

Benefits, drawbacks, and adverse effects should be discussed and carefully considered depending on disease type and a person’s clinical history and health.

Researchers and health providers are also committed to finding the best ways to use precision medicine and other personalized approaches to identify the most suitable immunotherapy drugs for patients.

About the Author

A freelance writer who specializes in medical and life science topics. As a trained researcher, she authored journal articles in the areas of infection and immunity and wrote booklets and book chapters about different diseases. As a professional communicator, she writes feature articles for magazines and other publications and develops content for higher education platforms. Damiana is also an experienced academic editor, microbiology educator, writing coach, and fragrance blogger. She is a contributing member of the American Medical Writers Association and a past-president of the association’s Southwest Chapter.

Damiana Chiavolini, MS, PhD Freelance Writer for GAI

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