Analysis on the efficacy and safety of belimumab in treatment of lupus nephritis in children

TANG Huihe; DAI Yan; LI Xinye; LU Fuqing; ZHANG Diwen; WEN Xiaoling; WEN Zhihong; YOU Yanwu

doi:10.3969/j.issn.1674-3806.2024.09.06

Abstract：Objective To analyze the efficacy and safety of belimumab in treatment of lupus nephritis(LN)in children.Methods The clinical data of 12 pediatric patients with LN who received the treatment of belimumab for 20 weeks in Department of Pediatrics,the People's Hospital of Guangxi Zhuang Autonomous Region from July 1,2021 to July 31,2024 were retrospectively collected.The clinical manifestations,changes in immune and urinary system-related indicators,changes in disease activity,reduction of glucocorticoids and adverse drug reactions of the pediatric patients were analyzed before and after treatment.Results Compared with those before belimumab treatment,the proportions of the pediatric patients with rash,fever,lupus nephritis and blood system damage decreased,and the dosage of glucocorticoids decreased,and the CD19+cell count decreased,and the positive rate of anti-double stranded deoxyribonucleic acid(dsDNA)antibodies decreased,and 24-hour urinary protein quantification,urinary red blood cell count and urinary white blood cell count decreased after belimumab treatment,and the differences were statistically significant(P＜0.05).There were statistically significant differences(P＜0.01)in the Systemic Lupus Erythematosus(SLE)Disease Activity Index-2000(SLEDAI-2000)scores of the pediatric patients treated with belimumab at different time points(0,2,4,8,12,16,20 weeks),and the scores showed a downward trend with the extension of treatment time.Among the 12 pediatric patients with LN,5 cases reached lupus low disease activity state(LLDAS)by the observation endpoint(20 weeks),and 3 cases reached clinical remission.During the study period,none of the pediatric patients had severe infection events and allergic reactions to belimumab.Conclusion Belimumab helps to reduce SLED AI-2000 scores and alleviate kidney injury in padiatric patients with LN,and helps to achieve LLDAS and clinical remission status,and helps to reduce the dosage of glucocorticoids to reduce adverse reactions.