Efficacy of belimumab in the treatment of systemic lupus erythematosus and its impact on T lymphocytes changes
CHEN Chao
LI Wengen
HAN Yanying
ZHAN Yaping
ZHANG Ke
Abstract：Objective To investigate the efficacy of belimumab in the treatment of systemic lupus erythematosus(SLE)and its impact on T lymphocytes changes.Methods A single-group retrospective longitudinal study was conducted.A total of 78 patients with SLE who were treated with belimumab at Meizhou People's Hospital in Guangdong Province between May 2021 and December 2024 were retrospectively enrolled.Blood routine parameters,cardiac,hepatic,and renal function in-dicators,immunological markers,and T lymphocyte subset changes before treatment and at 4,12,and 24 weeks post-treatment were compared.Results The white blood cell count after 24 weeks of treatment(6.10(4.38,7.25)×109/L)was significantly lower than that after 4 weeks(7.25(4.88,9.55)×109/L),and the difference was statistically significant(Z=10.679,P=0.014).The neutrophil-to-lymphocyte ratio at 12 and 24 weeks post-treatment(1.83(0.95,3.11),1.24(0.74,2.22))was lower than that before treatment and at 4 weeks post-treatment(3.08(2.20,5.92),3.13(1.93,5.14)),and the differences were statistical-ly significant(Z=78.845,P<0.001).The red blood cell levels at 12 and 24 weeks after treatment and the hemoglobin levels at 12 weeks after treatment((4.24±0.61)×1012/L,(4.22±0.58)×1012/L,(119.51±18.71)g/L)were significantly higher than those before treatment and after 4 weeks((3.89±0.82)×1012/L,(3.90±0.69)×1012/L,(111.26±22.43)g/L),and the differences were statistically significant(F=6.300,4.062,both P<0.001).The creatine kinase/creatine kinase isoenzyme MB after 12 and 24 weeks of treatment(3.47(2.38,4.64),3.81(2.75,5.45))were significantly higher than that after 4 weeks of treatment(2.53(1.69,3.90)),and the difference was statistically significant(Z=26.145,P<0.001).The 24-hour urine protein after 24 weeks of treatment(0.35(0.07,1.30)g/24 h)was significantly lower than that before treatment(1.36(0.20,4.25)g/24 h),and the difference was statistically significant(Z=15.741,P=0.001).The levels of immunoglobulin G at 4,12,and 24 weeks post-treat-ment(9.44(6.25,12.63),8.80(6.99,12.03),and 9.00(7.69,11.24)g/L)were lower than that before treatment(12.10(8.23,16.47)g/L),and the difference was statistically significant(Z=16.355,P=0.001).The immunoglobulin A and immunoglobulin M after 24 weeks of treatment(1.54(1.19,2.13),0.62(0.38,0.90)g/L))were lower than those before treatment(1.93(1.41,2.69),0.87(0.50,1.17)g/L),and the differences were statistically significant(Z=9.368,9.725,P=0.025,0.021).The comple-ment C3(0.60(0.46,0.69),0.68(0.56,0.90),0.72(0.57,0.87)g/L)and complement C4(0.11(0.09,0.17),0.14(0.10,0.20),0.13(0.12,0.22)g/L))after 4,12,and 24 weeks of treatment were significantly higher than those before treatment(the complement C3:0.48(0.38,0.62)g/L,the complement C4:0.09(0.05,0.11)g/L)),and the differences were statistically significant(Z=58.180,55.299,both P<0.001).The percentages of CD3+cells after 12 and 24 weeks of treatment((83.81±5.98)%and(84.53±6.10)%)were significantly higher than those before treatment and after 4 weeks of treatment((77.61±10.53)%and(77.82±8.18)%,re-spectively),and the difference was statistically significant(F=17.397,P<0.001).The percentages of CD3+CD8+cells after 12 and 24 weeks of treatment((44.41±12.17)%and(44.43±10.85)%)were significantly higher than those before treatment and after 4 weeks of treatment((39.80±12.24)%and(40.50±11.61)%,respectively),and the difference was statistically significant(F=3.491,P=0.016).The percentages of CD3+CD4+cells after 12 and 24 weeks of treatment((37.10±10.24)%,(37.26±9.01)%)were higher than that before treatment((32.96±10.09)%),and the difference was statistically significant(F=3.639,P=0.013).The percentage of CD16+CD56+cells after 24 weeks of treatment(6.56(4.01,9.50)%)was higher than that after 4 weeks of treatment(4.58(2.60,8.49)%),and the difference was statistically significant(Z=9.578,P=0.023).The percentages CD19+cells after 12 and 24 weeks of treatment(8.55(4.76,12.02)%,6.61(3.75,9.36)%)were lower than those before treatment and after 4 weeks of treatment(14.04(7.04,20.88)%,14.52(7.95,23.43)%),and the difference was statistically significant(Z=54.086,P<0.001).Conclusion Belimumab in the treatment of SLE can effectively reduce inflammatory damage in patients,improve renal func-tion,relieve anemia symptoms,regulate the balance between humoral immunity and cellular immunity,and comprehensively enhance the overall immune function of patients.
Keywords：systemic lupus erythematosusbelimumabT lymphocyte subsetshumoral immunitycellular immunity
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：6( 406-411 )