Results from a Phase I first in-human trial from Queensland shows that a single injection of autologous modified dendritic cells exposed to citrullinated peptides can suppress immune response in patients with RA.

HLA risk genotype-positive RA patients who received the immunotherapy treatment Rheumavax had a reduced number of effector T cells and a decreased production of proinflammatory cytokines one month after treatment compared to RA control patients, the research team from UQ Diamantina Institute reported in Science Translational Medicine.

Treatment did not induce disease flares in patients recruited with low disease activity and in patients with active disease DAS28 was reduced.

The results demonstrate the safety and biological activity of  rheumavax but further studies were needed to assess clinical efficacy and antigen-specific effects of autoantigen immunomodulatory therapy in RA, the researchers said.

Lead author and immunologist Professor Ranjeny Thomas said that at this stage the technique would not be ideal for widespread treatment or prevention of rheumatoid arthritis because it was costly and time-consuming.

“However, the promising results of this trial lay the foundations for the development of a more cost effective, clinically-practical vaccine technology that could deliver similar outcomes for patients,” she said.

The study involved 34 ACPA positive RA patients carrying HLA-DRB1 SE alleles, 9 who were treated with low dose and 9 with high-dose Rheumavax, and 16 RA controls who were untreated.

All patients were being treated with DMARDs and median disease duration was three years and two years for the low dose and high dose groups respectively. Baseline disease activity score (DAS28CRP) was 2.43 and 2.2.

Adverse events included transient new leukopenia or lymphopenia in six patients, transient anaemia in two, and transient new elevation of liver transaminases in two.