Background Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by an immune dysregulation and autoantibodies production. Kidney affection appears in around 40% of patients and eventually condition the prognosis, morbidity and mortality. Lupus nephritis (LN) is classified into 6 types, being the worst prognosis types III and IV.
Belimumab is a monoclonal antibody targeting BLyS approved for SLE, but currently it had no lupus nephritis (NL) indication. In 2020, promising results from a controlled Belimumab trial in LN were published.
Objective To analyze effectiveness of subcutaneous or intravenous Belimumab in LN patients under follow-up by the rheumatology department of a tertiary hospital.
Methods Observational, retrospective, and cross-sectional study including SLE patients according to SLICC/ACR 2012 criteria treated with Belimumab subcutaneous or intravenous. Patients had kidney affection based on pathological findings (kidney biopsy) or urine sediment alterations. A clinical history review was made and serological data, kidney function and urine sediment were collected.
Results From a total of 29 patients treated with belimumab, 9 presented kidney affection. In this group, 8 patients had lupus nephritis demonstrated by kidney biopsy and one patient had an active urine sediment. For them, median age was 37.56 (7.03) years, with 15.13 (8.71) years since SLE diagnosis was made and 4.61 (2.64) years since onset of belimumab. Regarding to type of nephritis, most prevalent type was III (33.3%), followed by type IV (22.22%). Two patients presented combination of both types III and IV and only one patient had type V.
The results obtained were included in the table.
Conclusions In clinical practice, belimumab can improve LN in terms of serological activity, kidney function and urine sediment. It could be a promising option associated to standard therapy for SLE patients with kidney affection. As a future aim, we propose to homogenize therapeutic efficacy definition in order to compare studies and to obtain common conclusions.
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