Reset vs Management: Debate for Treatment-Refractory Lupus Nephritis

Drs. Wise and Stohl discuss emerging cell therapies for refractory lupus, focusing on the CASTLE trial and its promising early results in resetting the immune system and achieving treatment-free remission. They balance enthusiasm with caution, stressing unknown long-term safety, practical, and logistical barriers, and the need to avoid overselling these therapies as a near-term cure.