Abstract: TH-PO637
Efficacy and Safety of Belimumab in Severe Lupus Nephritis: A Retrospective Single-Center Study
Session Information
- Lupus Nephritis: Clinical, Outcomes, and Therapeutics
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Aierken, Ailima, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Zhuang, Jing, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Yang, Shufen, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Yalikun, Dilina, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Xu, Chengren, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Zhang, Changrong, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
- Tian, Xuefei, Yale University School of Medicine, New Haven, Connecticut, United States
- Jiang, Hong, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
Background
Belimumab is a novel biological agent approved for the treatment of active lupus nephritis (LN), but its efficacy in severe LN has not been fully clarified. This study aimed to evaluate the efficacy and safety of belimumab combined with standard therapy in adult patients with severe active LN compared to standard therapy alone.
Methods
This observational and retrospective single-center study included 36 adult patients with severe active LN. Among them, 18 patients received belimumab combined with standard treatment, while another 18 patients received standard treatment. Demographic, clinical, laboratory, efficacy, and safety variables were collected. Effectiveness was evaluated based on changes from baseline in SLEDAI scores and disease activity markers. Safety data included any adverse event (AE) due to any cause.
Results
The baseline demographic and clinical characteristics of the two groups were similar, with no statistical differences. At week 24, the complete remission rate of renal involvement was significantly higher in the belimumab group compared to the control group (55.6% vs. 33.3%, P = 0.01). The proportion of partial remission of renal involvement was higher in the belimumab group (44.4% vs. 27.8%, P = 0.01). Seven cases of renal involvement in the control group did not reach remission. At week 24, the average SLEDAI score in the belimumab group decreased from 21.67 ± 3.69 at baseline to 6.11 ± 2.423, and the proportion of patients with SLEDAI scores ≤ 4 was higher in the belimumab group than in the control group (38.9% vs. 0%, P = 0.008). At week 24, patients treated with belimumab had a lower proportion of average daily hormone doses (≤ 5 mg/d: 0% vs. 61.6%) compared to the control group. Five patients in the belimumab group required dialysis initially; after treatment, though 2 remained in stage 4 chronic kidney disease, all 5 were off dialysis. The belimumab group was well-tolerated, with an incidence of adverse events similar to the control group. Belimumab did not significantly increase the risk of infection, even during the induction period of LN treatment.
Conclusion
The results of this study indicate that belimumab combined with standard treatment can improve the overall remission rate of severe LN, reduce disease activity, and decrease hormone exposure time while maintaining safety.