Durable renal response and safety with add-on belimumab in patients with lupus nephritis in real-life setting (BeRLiSS-LN). Results from a large, nationwide, multicentric cohort.

Adult Antibodies, Monoclonal, Humanized / therapeutic use B-Cell Activating Factor / immunology Cohort Studies Female Follow-Up Studies Glomerular Filtration Rate Humans Immunosuppressive Agents Italy Kidney / drug effects Lupus Erythematosus, Systemic / drug therapy Lupus Nephritis / drug therapy Male Middle Aged Proteinuria Treatment Outcome

Belimumab Lupus nephritis Renal response

Journal

Journal of autoimmunity

ISSN: 1095-9157

Titre abrégé: J Autoimmun

Pays: England

ID NLM: 8812164

Informations de publication

Date de publication:
11 2021

Historique:

received: 28 07 2021

revised: 22 09 2021

accepted: 24 09 2021

pubmed: 3 10 2021

medline: 11 3 2022

entrez: 2 10 2021

Statut: ppublish

Résumé

Belimumab was recently approved for treatment of lupus glomerulonephritis (LN). To evaluate renal response and its predictors in LN patients receiving belimumab in real-life. We considered all patients fulfilling the SLEDAI-2K renal items and/or having estimated glomerular filtration rate (eGFR)≤60 ml/min/1.73 m Among the 466 SLE patients of BeRLiSS, 91 fulfilled the inclusion criteria, 79 females, median age 41.0 (33.0-47.0) years, median follow-up 22.0 (12.0-36.0) months. Sixty-four (70.3%) achieved PERR, of whom 38.4% reached CRR. Among patients achieving PERR at 6 months, 86.7% maintained response throughout the follow-up. At multivariable analysis, hypertension (OR [95%CI]: 0.28 [0.09-0.89], p = 0.032), high baseline serum creatinine (0.97 [0.95-0.99], p = 0.01) and high baseline proteinuria (0.37, [0.19-0.74], p = 0.005) negatively predicted PERR. Positive predictors of PERR at 12 and 24 months were baseline anti-Sm positivity (OR [95%CI]: 6.2 [1.21-31.7], p = 0.029; 19.8 [2.01-186.7], p = 0.009, respectively) and having achieved PERR at 6 months (14.4 [3.28-63.6]; 11.7 [2.7-48.7], p = 0.001 for both). Add-on therapy with belimumab led to durable renal response in patients with LN in a real-life setting.

Sections du résumé

BACKGROUND

Belimumab was recently approved for treatment of lupus glomerulonephritis (LN).

AIM

To evaluate renal response and its predictors in LN patients receiving belimumab in real-life.

PATIENTS AND METHODS

We considered all patients fulfilling the SLEDAI-2K renal items and/or having estimated glomerular filtration rate (eGFR)≤60 ml/min/1.73 m

RESULTS

Among the 466 SLE patients of BeRLiSS, 91 fulfilled the inclusion criteria, 79 females, median age 41.0 (33.0-47.0) years, median follow-up 22.0 (12.0-36.0) months. Sixty-four (70.3%) achieved PERR, of whom 38.4% reached CRR. Among patients achieving PERR at 6 months, 86.7% maintained response throughout the follow-up. At multivariable analysis, hypertension (OR [95%CI]: 0.28 [0.09-0.89], p = 0.032), high baseline serum creatinine (0.97 [0.95-0.99], p = 0.01) and high baseline proteinuria (0.37, [0.19-0.74], p = 0.005) negatively predicted PERR. Positive predictors of PERR at 12 and 24 months were baseline anti-Sm positivity (OR [95%CI]: 6.2 [1.21-31.7], p = 0.029; 19.8 [2.01-186.7], p = 0.009, respectively) and having achieved PERR at 6 months (14.4 [3.28-63.6]; 11.7 [2.7-48.7], p = 0.001 for both).

CONCLUSIONS

Add-on therapy with belimumab led to durable renal response in patients with LN in a real-life setting.

Identifiants

DOI: 10.1016/j.jaut.2021.102729 PMID: 34600347

pubmed: 34600347

pii: S0896-8411(21)00137-2

doi: 10.1016/j.jaut.2021.102729

pii:

doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0

B-Cell Activating Factor 0

Immunosuppressive Agents 0

belimumab 73B0K5S26A

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

102729