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Belimumab may decrease flare rate and allow glucocorticoid withdrawal in lupus nephritis (including dialysis and

Valentina Binda1, Barbara Trezzi2, Nicoletta Del Papa3

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Belimumab effectively treated lupus nephritis (LN) symptoms, allowing for reduced corticosteroid use in most patients. This study highlights belimumab

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Area of Science:

  • Nephrology
  • Immunology
  • Rheumatology

Background:

  • Belimumab is approved for active lupus but data on lupus nephritis (LN) efficacy is limited.
  • Lupus nephritis requires effective treatments to manage renal and extrarenal manifestations.

Purpose of the Study:

  • To evaluate the efficacy and safety of belimumab in patients with lupus nephritis.
  • To assess the potential for corticosteroid dose reduction during belimumab therapy.

Main Methods:

  • A cohort of 17 female lupus nephritis patients received belimumab for a median of 36 months.
  • Treatment indications included arthralgia, cutaneous manifestations, proteinuria, and steroid-sparing needs.
  • One patient received belimumab during peritoneal dialysis and post-kidney transplantation.

Main Results:

  • Complete resolution of arthralgia and skin manifestations was observed in all patients.
  • Proteinuria normalized or stabilized in most patients, with significant steroid reduction or cessation in 100% of patients.
  • Low rates of lupus flares (0.02/patient/year) and no major adverse events requiring treatment withdrawal were reported.

Conclusions:

  • Belimumab facilitates complete response and corticosteroid withdrawal or reduction in nearly all lupus nephritis patients.
  • The drug demonstrated satisfactory use in a patient undergoing peritoneal dialysis and after kidney transplantation.