Exton, PA, Oct. 01, 2026 (GLOBE NEWSWIRE) -- Spherix Global Insights today announced the publication of its 2026 Special Topix™: Cell Therapy in Rheumatology (US) report, providing a comprehensive look at how U.S. rheumatologists view the rapidly evolving immune reset landscape across autologous and allogeneic CAR T, in vivo CAR T, CAR-NK, and T-cell engager approaches.
The study was initially fielded among 105 U.S. rheumatologists from July 29 to August 7, 2026. Following the August 31 reports that Novartis had paused autoimmune trials of rapcabtagene autoleucel (rap-cel/YTB323) following three patient deaths and that Bristol Myers Squibb had paused autoimmune trials of zola-cel following inflammatory adverse events, Spherix rapidly recontacted 76 of the same physicians from September 1–3, providing a longitudinal view of how these safety developments changed physician perceptions in real time.
Safety Events Shift the Market from Building Awareness to Rebuilding Confidence
The results show a market that remains highly interested in the potential of immune reset, but where the commercial conversation has shifted from building awareness to rebuilding confidence. After reviewing the safety-event information, mean physician confidence in autologous CAR T fell significantly from 7.5 to 5.2 on a 10-point scale, while the risk of side effects increased sharply as a barrier to clinical-trial referral.
Importantly, rather than prompting a wholesale shift away from autologous CAR T, the events increased caution across the broader immune reset category. Safety concerns extended to allogeneic CAR T, CAR-NK, in vivo approaches, and T-cell engagers, suggesting that competing platforms may not automatically benefit from concerns surrounding conventional autologous CAR T.
Autologous CAR T Retains Its Lead Despite the Safety Shock
Despite the decline in overall confidence, autologous CAR T retained its relative position among the emerging modalities evaluated. Post-event, 49% of rheumatologists ranked autologous CAR T as their first choice, compared with 28% for T-cell engagers and 16% for in vivo CAR T. This relative preference reflects the modality’s more established evidence base and potential for a personalized, one-time immune reset, rather than a restoration of confidence following the safety events.
At the same time, rheumatologists continue to see potential in approaches that could reduce the logistical and manufacturing burden associated with conventional autologous cell therapy. T-cell engagers offer off-the-shelf availability, simpler implementation, and flexible dosing, but physician preferences remain divided. In vivo CAR T also generates considerable interest because of its potential to eliminate cell collection and external manufacturing, shorten time to treatment, and potentially avoid lymphodepleting chemotherapy. For both approaches, however, durability and long-term safety remain important evidence needs.
Systemic Sclerosis Remains as the Clearest Near-Term Opportunity
Systemic sclerosis (SSc) stands apart as the condition with the greatest perceived unmet need for immune reset therapy. More than two-thirds of rheumatologists ranked SSc first for unmet need among the nine autoimmune conditions evaluated, well ahead of idiopathic inflammatory myopathies and lupus nephritis.
Across diseases, physicians are most likely to view immune reset as appropriate for patients with refractory or treatment-resistant disease, significant organ involvement, or relapse following B-cell depletion. These findings suggest that early adoption is likely to concentrate among patients whose disease severity and limited remaining options may justify the risks and complexity of intensive therapy.
Delivery Infrastructure May Be as Important as Clinical Demand
The findings also point to a meaningful gap between patients whom physicians consider candidates for immune reset and those they expect will ultimately receive treatment. Access to specialized gene or cell therapy centers, safety concerns, and patient travel burden are among the barriers likely to narrow the treatable population.
Alternative delivery models could help close that gap. Nearly seven in ten rheumatologists say outpatient availability would make them more likely to prescribe or refer for cell therapy, while approximately two-thirds are very open to both referral-based and shared or hybrid care models. For manufacturers, the findings suggest that commercialization will require not only compelling clinical evidence, but scalable treatment networks that connect rheumatologists, specialized centers, and patients.
Patient Interest Remains, but the Bar for Adoption Is Rising
The study also points to substantial underlying patient interest. Before the safety events, more than half of rheumatologists reported that their patients had become more open to cell therapy over the prior year, with physicians describing particularly strong interest among patients facing severe or refractory disease.
At the same time, the same factors that define the opportunity also constrain it: safety, treatment-center access, travel burden, and treatment intensity are likely to influence whether clinical interest translates into real-world use.
Differentiation Will Require More Than Efficacy
For pharmaceutical and biotechnology companies developing immune reset therapies, the findings highlight a market in which efficacy alone may no longer be sufficient to differentiate. Manufacturers will need to demonstrate how their approach balances depth and durability of response with safety, scalability, patient burden, and the practical realities of delivering treatment across academic and community settings. Following the recent trial pauses, credible product-specific safety evidence, and clarity around whether observed risks are product-, platform-, or class-related, will be particularly important to rebuilding physician confidence.
“The commercial opportunity remains significant, but the path to adoption is becoming more nuanced,” said Sawyer May, Rheumatology Insights Director at Spherix Global Insights. “Companies need to understand not only which modality physicians prefer, but which patients they will actually nominate, what evidence will change behavior, and which care models can convert clinical interest into real-world use.”
Special Topix™: Cell Therapy in Rheumatology (US) 2026 marks the second consecutive year Spherix has examined rheumatologist perceptions of the evolving immune reset landscape. This year’s research combines year-over-year benchmarks with a longitudinal pre-/post-event analysis, providing a unique view into how major market developments are shaping physician confidence, modality preferences, patient selection, and expectations for adoption.
About Special Topix™
Special Topix™ is an independent service that includes access to a report or series of reports based on current events or topics of interest in specialty markets covered by Spherix.
About Spherix Global Insights
Spherix Global Insights is a leading independent provider of market intelligence and advisory services for specialty pharmaceutical and biotech markets. By combining physician, patient, and payer perspectives into an integrated view, Spherix helps brand teams, market access stakeholders, and investors understand how a specialty market actually behaves, not how any one stakeholder describes it.
The firm operates ten dedicated therapeutic franchises – Dermatology, Gastroenterology, Hematology, Nephrology, Neuroscience, Obesity, Oncology, Ophthalmology, Respiratory and Rheumatology – plus a Market Access team. Each franchise is staffed by hyper-focused experts who track these markets full-time, drawing on independently curated communities of vetted specialists, patients, and payers to deliver quarterly trending, launch tracking, chart audits, and KOL synthesis.
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Jim Hickey Spherix Global Insights 484-879-4284 james.hickey@spherixglobalinights.com
