A first-in-human clinical trial at Charité has reported that a CD19 CAR T-cell therapy induced substantial disease activity decreases in six patients with treatment-refractory seropositive rheumatoid arthritis. Follow-up across 36–52 weeks included stopping background disease-modifying antirheumatic drugs prior to infusion and using standard lymphodepletion. The study reported that three of the six patients achieved sustained remission without RA medication by the end of observation. The trial design included ACPA-positive patients with a long history of inadequate responses to up to eight prior targeted or biologic therapies. While early and small, the results provide direct proof-of-concept for CAR T approaches extending beyond oncology into durable B-cell driven autoimmune remission strategies.