Efficacy and safety of belimumab in lupus nephritis: A retrospective study

Objective: This retrospective analysis was to examine the efficacy and safety of belimumab in lupus nephritis in China. Materials and methods: 25 patients who were regularly followed up every 3 months in our hospital in China were included. All patients were diagnosed as having lupus nephritis and received belimumab to complement standard therapy. The primary outcomes 24-hour proteinuria, complement level, estimated glomerular filtration rate (eGFR), SELENA-SLEDAI scores, prednisone daily dose, and adverse reactions were recorded at 12, 24, 36, and 48 weeks. Results: The SELENA-SLEDAI scores and 24-hour urine protein of the 25 patients decreased visibly from baseline 15.96 +/- 3.02, 1.52 +/- 1.72 to 9.52 +/- 2.66 (p < 0.01), 0.5 +/- 0.2 (p < 0.05) at 48 weeks, the eGFR of the 25 patients increased from 76.45 +/- 22.2 to 85.48 +/- 19.26 (p < 0.01) at 48 weeks, complement levels also showed a trend to increase. One patient experienced renal flare at 48 weeks, and the level of the patient's 24-hour proteinuria had been > 0.7 g at 6 months; this may be a strong predictive factor for further renal response at 12 months. Belimumab added to the standard therapy also improved the hematologic complications caused by systemic lupus erythematosus in 2 patients with a lower glucocorticoid dose. There were no serious adverse events. Conclusion: Belimumab may be effective and safe in lupus nephritis even with regard to hematologic complications.