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By Dr Pranab Gyawali, Consultant Gastroenterologist

In this video, I talk through a recent case of CAR-T therapy used in ulcerative colitis and why it has generated so much interest.

For those who want to look at the original report, you can read the journal case here: PubMed journal case report.

What exactly was reported in this case?

This was a 21-year-old patient with severe ulcerative colitis who had not responded to multiple biologics including infliximab, ustekinumab, ozanimod, vedolizumab, upadacitinib and mirikizumab.

Despite this, the disease remained active and surgery was being considered.

After CAR-T therapy, the patient went into remission within weeks and was off all medication at follow-up.

What is CAR-T therapy and how does it work?

CAR-T therapy diagram showing blood removed, laboratory processing, and blood returned in ulcerative colitis treatment
Illustration of CAR-T therapy. Blood is removed, processed in the lab, and then returned to the body.

CAR-T therapy is a treatment where immune cells are taken from the blood, modified in a laboratory, and then returned to the body.

Unlike biologics, which block inflammation signals, this approach targets immune cells directly, suggesting a reset of the immune system rather than just control.

Why is this different from what we usually do?

Most treatments for ulcerative colitis, including biologics, work by blocking specific parts of the inflammatory process.

CAR-T therapy works at a deeper level by targeting immune cells themselves.

Does this mean CAR-T therapy is now a treatment option?

No.

This is a single case, and CAR-T therapy is not something we are using routinely for ulcerative colitis.

It is a complex and intensive treatment currently used mainly in cancer care and only being explored in immune conditions.

So why does this matter?

It matters because it shows what may be possible.

If this kind of response can be repeated, it suggests that in some patients, we may need to think beyond simply blocking inflammation.

It points towards a different treatment approach.

What are the limitations?

This is early data.

It is one patient.

It is not scalable in its current form.

And it carries risks that require specialist care.

What could this mean going forward?

If further studies show similar results, the real value will not be CAR-T itself.

It will be the development of simpler, safer treatments that can achieve the same kind of effect.

What next? (Part 2)

In the next video, I will talk through what happened to this patient after 8 months, based on follow-up data presented at a conference.

CAR-T Therapy in Ulcerative Colitis: Part 2 Update

This short update reviews what happened next after initial remission at eight months in the patient.

👉 Watch the Part 2 update below:

FAQ

What exactly was reported in this CAR-T therapy ulcerative colitis case?

This was a 21-year-old patient with severe ulcerative colitis who had not responded to multiple biologics including infliximab, ustekinumab, ozanimod, vedolizumab, upadacitinib and mirikizumab. After CAR-T therapy, the patient went into remission within weeks and was off all medication at follow-up.

How is CAR-T therapy different from biologics in ulcerative colitis?

Most biologics work by blocking inflammatory signals. CAR-T therapy targets immune cells themselves, suggesting a deeper immune reset rather than simply controlling inflammation.

Is CAR-T therapy available as a routine treatment for ulcerative colitis in Dubai?

No. This is a single case report and CAR-T therapy is not currently used as a routine treatment for ulcerative colitis.

Why does this case matter for the future of ulcerative colitis treatment?

It matters because it suggests a different treatment direction. If similar responses are reproduced, future therapies may become simpler and safer while aiming to achieve the same kind of deeper immune reset.

Recommended Guides

Ulcerative Colitis Basics & Patient Education

Biologics / Treatment section

Ulcerative Colitis Diet, Lifestyle & Flare Control

Gut Microbiome, Leaky Gut & Overlooked Issues

Nutritional Deficiencies & Complications in IBD

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PATIENT REVIEWS

I recently had a microbiome test conducted by Dr. Pranab, and the experience was exceptional. Dr. Pranab is a great doctor—very professional and knowledgeable. He thoroughly explained my test results and provided detailed insights into how to care for my gut health.