Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus
- VernacularTitle:9例利妥昔单抗序贯贝利尤单抗治疗重症系统性红斑狼疮的临床观察
- Author:
Yuanxia ZHAO
1
;
Guanmin GAO
2
;
Xiaojing LU
1
;
Yaojuan CHU
1
;
Song WANG
1
;
Xiangfen SHI
1
;
Shuzhang DU
1
;
Xiaojian ZHANG
1
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
2. Dept. of Rheumatology and Immunology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
- Publication Type:Journal Article
- Keywords:
belimumab;
rituximab;
severe systemic lupus erythematosus;
clinical efficacy;
safety
- From:
China Pharmacy
2023;34(7):849-853
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the clinical efficacy and safety of rituximab （RTX） followed by belimumab （BLM） in patients with severe systemic lupus erythematosus（SSLE）. METHODS Nine SSLE patients， who were treated with RTX followed by BLM for more than 6 months in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Zhengzhou University from October 2020 to June 2021， were enrolled. Baseline clinical data of patients， laboratory examination results and basic treatment status at weeks 0， 4， 12， and 24 of medication were collected retrospectively. The patients’ systemic lupus erythematosus disease activity index （SLEDAI） score， glucocorticoid dosage and serological indicators （complement C3， complement C4， serum albumin， and 24-hour urine protein quantification） level were analyzed. At the same time， the occurrence of adverse drug reaction was collected. RESULTS All 9 patients completed more than 24 weeks of RTX followed by BLM therapy. All patients suffered from renal impairment， of which 7 （77.8%） had renal pathology support， 3（33.3%） had blood system damage and 2 （22.2%） had nervous system damage. During treatment， with the prolongation of treatment time， the SLEDAI score， 24- hour urinary protein quantification， and glucocorticoid dosage of patients showed a significant downward trend， and ultimately decreased to the normal index level （P＜0.05）； serum albumin， complement C3 and complement C4 all showed a significant upward trend， eventually rose to the normal index level （P＜0.05）. During treatment and follow-up， 1 patient developed herpes zoster， 1 patient developed upper respiratory tract virus infection， and 1 patient developed urinary system bacterial infection. All patients recovered after symptomatic treatment. CONCLUSIONS In sequential use of RTX followed by BLM for SSLE， early administration of RTX can quickly stabilizethe condition， significantly alleviate clinical symptoms， and gradually normalize specific serological indicators； subsequent administration of BLM can reduce the type and dosage of basic treatment drugs； there is no increase in the incidence of adverse drug reactions.
