A patient with systemic lupus erythematosus and lupus nephritis: the potentials for biological therapy


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. evaluation of the clinical and laboratory dynamics of patients with systemic lupus erythematosus (SLE) and lupus nephritis (LN) during therapy with belimumab. material and methods. the study included 18 patients with sle and lupus kidney disease who received belimumab in addition to standard therapy. Evaluation of immunological parameters (anti-native double-stranded DNA antibody titers, сз, C4 complement component levels), biochemical parameters (cholesterol, creatinine, total blood protein levels), changes in clinical urinalysis (proteinuria, cylindruria, leukocyturia, erythrocyturia) was performed; dynamics of glomerular filtration rate (GFR), daily proteinuria and the selena-sledai index, obtained in different periods from the start of treatment with belimumab (о, 2, 6 and 12 months) were analyzed. results. The positive dynamics of clinical and laboratory symptoms (a decrease in the main disease symptoms, a positive dynamics of laboratory parameters and an improvement in the general condition) of patients were revealed. Conclusion. The use of belimumab at a dose of 10 mg/kg in addition to standard therapy for patients with sle and LN reduces the clinical and immunological activity of sle, decreases the level of daily proteinuria, decreases the creatinine level, and allows deescalating the dose of glucocorticosteroids taken.

Full Text

Restricted Access

About the authors

Nemanja Damyanov

University of Belgrade

Email: nemanjadamjanov@yahoo.com
Dr.Sci. (Med.), Professor, Head of the Department of Rheumatology, Faculty of Medicine

Irina B. Vinogradova

Ulyanovsk Regional Clinical Hospital

Email: kazvin@yandex.ru
Cand. Sci. (Med.), Head of the Department of Rheumatology

Artem V. Bezgin

Kursk Regional Clinical Hospital

Email: bezgin_artem@inbox.ru
Dr. Sci. (Med.), Nephrologist, Department of Nephrology

Larisa A. Knyazeva

OOO Medical Center № 1, Kursk

Email: larisa.x.kniazeva@gsk.com
Dr. Sci. (Med.), Professor, Head of the Department of Rheumatology

References

  1. Kaul A., Gordon C., Crow M.K., et al. Systemic lupus erythematosus. Nat. Rev. Dis. Primers. 2016;2:16039. doi: 10.1038/nrdp.2016.39.
  2. Tsokos G.C., Lo M.S., Costa Reis P., Sullivan K.E. New insights into the immunopathogenesis of systemic lupus erythematosus. Nat. Rev. Rheumatol. 2016;12(12):716-730. doi: 10.1038/nrrheum.
  3. Rekvig O.P. Autoimmunity and SLE: Factual and semantic evidence-based critical analyses of definitions, etiology, and pathogenesis. Front. Immunol. 2020;11:569234. doi: 10.3389/fimmu.2020.569234.
  4. Mahajan A., Amelio J. Gairy K., et al. Systemic lupus erythematosus, lupus nephritis and end-stage renal disease: a pragmatic review mapping disease severity and progression. Lupus. 2020;29:1011-1020.
  5. Hanly J.G., et al. The frequency and outcome of lupus nephritis: resultsfrom an international inception cohort study. Rheumatol. 2016;55:252-262.
  6. Piga M., Arnaud L. The main challenges in systemic lupus erythematosus: Where do we stand? J. Clin. Med. 2021;10(2):243. doi: 10.3390/jcm10020243.
  7. Lockshin M.D., Barbhaiya M., Izmirly P., et al. SLE: Reconciling heterogeneity. Lupus Sci. Med. 2019;6(1):280. doi: 10.1136/lupus-2018-000280.
  8. Lo M.S., Tsokos G.C. Recent developments in systemic lupus erythematosus pathogenesis and applications for therapy. Curr. Opin. Rheumatol. 2018;30(2):222-228. doi: 10.1097/BOR.0000000000.
  9. Furie R., Rovin B.H., Houssiau F., et al. Two-Year, Randomized, controlled trial of Belimumab in lupus nephritis. N. Engl. J. Med. 2020;383(12):1117-1128. doi: 10.1056/NEJMoa2001180.
  10. Cassese G., Lindenau S., de Boer B., et al. Inflamed kidneys of NZB/W. mice are a major site for the homeostasis of plasma cells. Eur. J. Immunol. 2001;31:2726-2732.
  11. Chang A., Henderson S.G., Brandt D., et al. In situ B. cell-mediated immune responses and tubulointerstitial inflammation in human lupus nephritis. J. Immunol. 2011;1861849-1860.
  12. Clark M.R., Trotter K., Chang A. The pathogenesis and therapeutic implications of tubulointerstitial inflammation in human lupus nephritis. Semin. Nephrol. 2015;35:455-464.
  13. Allen M.E., Rus V., Szeto G.L. Leveraging Heterogeneity in Systemic Lupus Erythematosus for New Therapies. Trends Mol. Med. 2021;2(2):152-171.
  14. Benlysta prescribing information. Research Triangle Park, NC: GlaxoSmith Kline, 2019. https://www.accessdatafda.gov/drugsatfda_docs/label/2019/125370s067,761043s005lbl.pdf.
  15. Dooley M.A., Houssiau F., Aranow C., et al. Effect of belimumab treatment on renal outcomes: results from the phase 3 belimumab clinical trials in patients with SLE. Lupus 2013;22:63-72.
  16. Furie R., Rovin B.H., Houssiau F., et al. Two-year, randomized, controlled trial of belimumab in lupus nephritis. N. Engl. J. Med. 2020;383:1117-1128. doi: 10.1136/annrheumdis-2020-216924.
  17. Российские клинические рекомендации «Ревматология». Под ред. Е.Л. Насонова. М., 2020. 132 с.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies