Therapeutic Effect of Belimumab in Lupus Nephritis with Impaired Renal Function

Le résumé fourni par la source

Background: To investigate the nephroprotective effect of belimumab (BEL) in SLE with mildly impaired renal function and proteinuria. Methods: We studied 28 patients in the maintenance phase of SLE who was treated with BEL for more than 6 months. The median duration of treatment was 14 months. The patients were divided into those with reduced eGFR less than 60 ml/min/1.73 m2 (n=5; R group) and those with normal renal function (n=23; N group), and the effects of BEL were compared 6 months after treatment. In addition, the effect of BEL on lupus nephritis was investigated in patients with urinary protein of 0.2 g/gCr or more. Results: The patients consisted of 26 females and 2 males, and the median age was 41 years. After BEL treatment, urinary protein decreased in both groups, 0.45 to 0.20 g/gCr in N group and 0.32 to 0.17 g/gCr in R group. The eGFR changed from 88.6 to 87.7 and from 50.8 to 61.2, while dsDNA antibodies (IU/mL) decreased from 54.9 to 30.5 and from 23.2 to 9.04, respectively. The doses of prednisolone (mg/day) decreased in both groups. The IgG level decreased from 1377 to 1204 (mg/dL) in N group and from 1009 to 865 in R group. In 18 patients with urinary protein of 0.2 g/gCr or more, proteinuria significantly decreased from 0.54 to 0.20 to 0.23 (g/gCr) and dsDNA antibody improved from 67 to 34 to 35.1 (IU/mL) at 3 and 6 months after BEL therapy. Conclusions: BEL may improve SLE activities and also renal function in patients with renal insufficiency as effectively as in those with normal renal function, although hypogammaglobulinemia comparably develops in both groups.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.