Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study
Objective Both belimumab and telitacicept are recognised blockers for B lymphocyte activation, both of which have been approved as add-on therapies for SLE in China. The aim of this study is to compare the efficacy of rituximab (RTX) followed by belimumab or telitacicept in a real-world cohort.Metho...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-01-01
|
| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/12/1/e001296.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841556474173587456 |
|---|---|
| author | Fei Han Hong Pan Yi Yang Jianghua Chen Jing Xue Lan Lan Yiting Chen Pingping Ren Yaomin Wang Xin Lei Jianhang Xu Xiaochan Chen Qiankun Zhang Junni Wang Nan Shi Liangliang Chen Lie Jin |
| author_facet | Fei Han Hong Pan Yi Yang Jianghua Chen Jing Xue Lan Lan Yiting Chen Pingping Ren Yaomin Wang Xin Lei Jianhang Xu Xiaochan Chen Qiankun Zhang Junni Wang Nan Shi Liangliang Chen Lie Jin |
| author_sort | Fei Han |
| collection | DOAJ |
| description | Objective Both belimumab and telitacicept are recognised blockers for B lymphocyte activation, both of which have been approved as add-on therapies for SLE in China. The aim of this study is to compare the efficacy of rituximab (RTX) followed by belimumab or telitacicept in a real-world cohort.Methods A total of 49 refractory lupus nephritis patients were enrolled from four independent centres, subsequently categorised into two treatment groups: belimumab group (n=35) and telitacicept group (n=14) based on their treatment following RTX. The outcomes of renal response rates were evaluated.Results In this study cohort, 63.3% presented with anti-dsDNA antibody positivity and 79.6% exhibited hypocomplementemia, with a mean Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) Score of 13±6, estimated glomerular filtration rate (eGFR) of 76.2 (30.2, 113.7) mL/min and urinary protein creatinine ratio (uPCR) of 2.45 (0.77, 5.19) g/g. There was no significant differences between groups. After a follow-up duration of 26±12 months, renal objective remission rate was 80.0% (28 patients) in belimumab group and 85.7% (12 patients) in telitacicept group (difference, 5.7 percentage points, 95% CI, −25.8 to 26.8, p=1.000). Renal complete response was 54.3% (19 patients) in belimumab group and 78.6% (11 patients) in telitacicept group (difference, 24.3 percentage points, 95% CI, 9.7 to 47.8, p=0.194). The anti-dsDNA antibody, complement, eGFR, uPCR and SLEDAI-2K Score were improved in both groups with a significant reduction in prednisone dose. Major adverse effects included immunoglobulin deficiency, respiratory tract infection and urinary tract infection. No death occurred.Conclusions The sequential treatment of belimumab or telitacicept following RTX may represent a promising therapeutic approach in the management of refractory lupus nephritis. Further investigation is necessary to establish optimal protocols and long-term benefits. |
| format | Article |
| id | doaj-art-13441f2adc36480c89662224d2027d2e |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-13441f2adc36480c89662224d2027d2e2025-01-07T08:05:08ZengBMJ Publishing GroupLupus Science and Medicine2053-87902025-01-0112110.1136/lupus-2024-001296Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre studyFei Han0Hong Pan1Yi Yang2Jianghua Chen3Jing Xue4Lan Lan5Yiting Chen6Pingping Ren7Yaomin Wang8Xin Lei9Jianhang Xu10Xiaochan Chen11Qiankun Zhang12Junni Wang13Nan Shi14Liangliang Chen15Lie Jin16Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDivision of Nephrology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, ChinaDivision of Nephrology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDivision of Nephrology, Lishui Central Hospital, Lishui, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDivision of Nephrology, Lishui Central Hospital, Lishui, Zhejiang, ChinaObjective Both belimumab and telitacicept are recognised blockers for B lymphocyte activation, both of which have been approved as add-on therapies for SLE in China. The aim of this study is to compare the efficacy of rituximab (RTX) followed by belimumab or telitacicept in a real-world cohort.Methods A total of 49 refractory lupus nephritis patients were enrolled from four independent centres, subsequently categorised into two treatment groups: belimumab group (n=35) and telitacicept group (n=14) based on their treatment following RTX. The outcomes of renal response rates were evaluated.Results In this study cohort, 63.3% presented with anti-dsDNA antibody positivity and 79.6% exhibited hypocomplementemia, with a mean Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) Score of 13±6, estimated glomerular filtration rate (eGFR) of 76.2 (30.2, 113.7) mL/min and urinary protein creatinine ratio (uPCR) of 2.45 (0.77, 5.19) g/g. There was no significant differences between groups. After a follow-up duration of 26±12 months, renal objective remission rate was 80.0% (28 patients) in belimumab group and 85.7% (12 patients) in telitacicept group (difference, 5.7 percentage points, 95% CI, −25.8 to 26.8, p=1.000). Renal complete response was 54.3% (19 patients) in belimumab group and 78.6% (11 patients) in telitacicept group (difference, 24.3 percentage points, 95% CI, 9.7 to 47.8, p=0.194). The anti-dsDNA antibody, complement, eGFR, uPCR and SLEDAI-2K Score were improved in both groups with a significant reduction in prednisone dose. Major adverse effects included immunoglobulin deficiency, respiratory tract infection and urinary tract infection. No death occurred.Conclusions The sequential treatment of belimumab or telitacicept following RTX may represent a promising therapeutic approach in the management of refractory lupus nephritis. Further investigation is necessary to establish optimal protocols and long-term benefits.https://lupus.bmj.com/content/12/1/e001296.full |
| spellingShingle | Fei Han Hong Pan Yi Yang Jianghua Chen Jing Xue Lan Lan Yiting Chen Pingping Ren Yaomin Wang Xin Lei Jianhang Xu Xiaochan Chen Qiankun Zhang Junni Wang Nan Shi Liangliang Chen Lie Jin Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study Lupus Science and Medicine |
| title | Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study |
| title_full | Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study |
| title_fullStr | Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study |
| title_full_unstemmed | Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study |
| title_short | Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study |
| title_sort | belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis a real world multicentre study |
| url | https://lupus.bmj.com/content/12/1/e001296.full |
| work_keys_str_mv | AT feihan belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT hongpan belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT yiyang belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT jianghuachen belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT jingxue belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT lanlan belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT yitingchen belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT pingpingren belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT yaominwang belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT xinlei belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT jianhangxu belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT xiaochanchen belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT qiankunzhang belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT junniwang belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT nanshi belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT liangliangchen belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy AT liejin belimumabversustelitaciceptinsequentialtreatmentafterrituximabforrefractorylupusnephritisarealworldmulticentrestudy |