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At 13:00 on June 2 (19:00 on June 2, Beijing time), the 2021 European Union Against Rheumatism Annual Conference (EULAR2021) officially opened online.
As one of the most important and authoritative conferences in the field of rheumatism and immunity, Yimaitong is authorized by EULAR to compile and organize part of the conference content and have an academic feast with you.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, and clinical diagnosis and treatment are extremely challenging.
In recent years, the progress of SLE treatment has been one of the hot topics in major academic conferences at home and abroad.
Believumab (BEL) is a recombinant fully human monoclonal antibody that specifically inhibits the activity of B cell stimulating factor (BLyS).
In 2019, BEL was approved in China and was approved to be used in combination with conventional treatments for active, autoantibody-positive SLE patients who still have high disease activity on the basis of conventional treatments.
As the world's first biological agent for the treatment of SLE, what is the efficacy and safety of belimumab in the treatment of SLE with glomerulonephritis (GN)? ●Real-world belyumumab treatment of lupus nephritis, safe and effective: from a large multi-center prospective cohort study background: the kidney is the most commonly involved organ of SLE, LN is one of the main complications of SLE.
Studies have confirmed that targeted drugs can effectively control LN, especially in patients with refractory LN.
Research purpose: To evaluate the renal remission of patients with SLE and GN in the real world treated with BEL.
Research method: In the Italian multi-center study (BeRLiSS study), SLE patients with proteinuria >0.
5 g/24 h and/or active deposition at baseline were included.
All patients received BEL IV 10 mg/kg+ standard treatment monthly.
Complete renal response (CRR) is defined as proteinuria <0.
5 g/24 h, estimated glomerular filtration rate (eGFR) ≥90ml/min/1.
73m2, and no salvage treatment.
The main effect of renal remission (PERR) is defined as proteinuria ≤0.
7 g/24 h, eGFR ≥60ml/min/1.
73m2, and no salvage treatment.
In addition, the study evaluated the proportion of patients who achieved CRR and PERR at 12 months and 24 months and corresponding predictive factors through multiple regression analysis.
Research results: A total of 91 patients were included in the study, 79 of which were female patients, with an average age of 40.
51±9.
03 years, a median illness time of 12.
18±8.
15 years, and a median follow-up time of 22 months after BEL treatment.
At baseline, 20 patients had proteinuria levels ranging from 0.
5 g/d to 1 g/d, 17 patients had proteinuria levels ranging from 1 g/d to 2 g/d, and 13 patients had proteinuria levels ≥ 2 g/d.
Twenty patients (22%) received BEL treatment at the onset of GN, and the remaining patients only started BEL treatment when renal involvement became worse.
Kidney biopsy of 75 patients showed: 1 case of type I; 4 cases of type II; 14 cases of type III; 47 cases of type IV; 9 cases of type V.
The baseline serum creatinine level was 82.
44±29.
26 umol/L, and 15 patients had eGFR<60ml/min/1.
73m2 at baseline.
Seventy patients (76.
9%) received the following immunosuppressive therapy: mycophenolate mofetil (n=47), azathioprine (n=15), cyclosporine (n=5).
Sixty patients (65.
9%) were treated with antimalarial drugs.
During the follow-up period, 34 patients (37.
4%) achieved CRR.
Among them, 5 patients (14.
7%) relapsed, and 29 patients (85.
3%) maintained remission.
The average time to reach CRR was 9.
71±5.
91 months.
Multiple regression analysis showed that the level of proteinuria at baseline was high at 6 months (CRR: OR 0.
044, 95% CI 0.
006-0.
320, p=0.
002; PERR: OR 0.
232, 95% CI 0.
091-0.
596, p=0.
002) and At 12 months (CRR: OR 0.
029, 95% CI 0.
002-0.
556, p=0.
019; PERR: OR 0.
056, 95% CI 0.
009-0.
327, p=0.
001) poor predictors of CRR and PERR.
High creatinine levels at baseline are an independent adverse factor in renal remission.
Renal remission at 6 months is a high predictor of renal remission in the subsequent 12 months and 24 months.
Research conclusions: In the real world, belyumumab is an effective treatment for patients with SLE and GN.
Yimaitong compiled and compiled from: 1.
Mesnyankina, et al.
EULAR 2021 Virtual Congress.
Abstract AB0284.
2.
S.
Sheikh, et al.
EULAR 2021 Virtual Congress.
Abstract AB0288.
3.
F.
Saccon, et al.
EULAR 2021 Virtual Congress.
Abstract POS0693.