Background: Belimumab (Benlysta) is currently approved for the treatment of active Lupus despite standard therapy. Few data are available on the efficacy of this drug in lupus nephritis (LN). Methods: 17 LN female followed in two Nephrology Italian Unit received belimumab for a median period of 36 months (range 6–42 months). The indications were: arthralgia in 3 patients, cutaneous manifestations in 2, residual proteinuria in 8, and the need to reduce steroids for severe side effects in 4. Of interest, 1 patient started therapy during Peritoneal Dialysis and continued after kidney transplantation due to non-responsive arthralgias. Results: Arthralgia and skin manifestations resolved in all patients. Proteinuria normalized in three patients and stabilized in all but one of the others. Steroids were indefinitely stopped in six patients (35%) and reduced to around 40% of the basal dosage in the other patients. During belimumab therapy, three extrarenal and one renal SLE flares were diagnosed accounting for a rate of renal flares of 0.02/patient/year. No major adverse events leading to therapy withdrawal occurred. Clinical case: Arthralgia resolved, immunological parameters improved and prednisone could be reduced within few months in the patient who started belimumab during peritoneal dialysis. After kidney transplantation belimumab was stopped but due to arthralgias unresponsive to standard immunosuppressive therapy it was restarted with success. Conclusions: Belimumab allows the achievement of complete response together with the withdrawal or the reduction of corticosteroids in almost all our patients. Of interest its satisfactory use in a patient in peritoneal dialysis and after kidney transplantation.

Binda, V., Trezzi, B., Del Papa, N., Beretta, L., Frontini, G., Porata, G., et al. (2020). Belimumab may decrease flare rate and allow glucocorticoid withdrawal in lupus nephritis (including dialysis and transplanted patient). JN. JOURNAL OF NEPHROLOGY, 33(5), 1019-1025 [10.1007/s40620-020-00706-3].

Belimumab may decrease flare rate and allow glucocorticoid withdrawal in lupus nephritis (including dialysis and transplanted patient)

Trezzi, Barbara;Fabbrini, Paolo
Membro del Collaboration Group
;
Pozzi, Maria Rosa
Membro del Collaboration Group
;
Sinico, Renato Alberto
Penultimo
Membro del Collaboration Group
;
Moroni, Gabriella
Ultimo
Membro del Collaboration Group
2020

Abstract

Background: Belimumab (Benlysta) is currently approved for the treatment of active Lupus despite standard therapy. Few data are available on the efficacy of this drug in lupus nephritis (LN). Methods: 17 LN female followed in two Nephrology Italian Unit received belimumab for a median period of 36 months (range 6–42 months). The indications were: arthralgia in 3 patients, cutaneous manifestations in 2, residual proteinuria in 8, and the need to reduce steroids for severe side effects in 4. Of interest, 1 patient started therapy during Peritoneal Dialysis and continued after kidney transplantation due to non-responsive arthralgias. Results: Arthralgia and skin manifestations resolved in all patients. Proteinuria normalized in three patients and stabilized in all but one of the others. Steroids were indefinitely stopped in six patients (35%) and reduced to around 40% of the basal dosage in the other patients. During belimumab therapy, three extrarenal and one renal SLE flares were diagnosed accounting for a rate of renal flares of 0.02/patient/year. No major adverse events leading to therapy withdrawal occurred. Clinical case: Arthralgia resolved, immunological parameters improved and prednisone could be reduced within few months in the patient who started belimumab during peritoneal dialysis. After kidney transplantation belimumab was stopped but due to arthralgias unresponsive to standard immunosuppressive therapy it was restarted with success. Conclusions: Belimumab allows the achievement of complete response together with the withdrawal or the reduction of corticosteroids in almost all our patients. Of interest its satisfactory use in a patient in peritoneal dialysis and after kidney transplantation.
Articolo in rivista - Articolo scientifico
Belimumab; Kidney transplantation; Lupus nephritis; SLE; Systemic lupus erythematosus;
Belimumab; Kidney transplantation; Lupus nephritis; SLE; Systemic lupus erythematosus
English
1019
1025
7
Published: 30 January 2020
Binda, V., Trezzi, B., Del Papa, N., Beretta, L., Frontini, G., Porata, G., et al. (2020). Belimumab may decrease flare rate and allow glucocorticoid withdrawal in lupus nephritis (including dialysis and transplanted patient). JN. JOURNAL OF NEPHROLOGY, 33(5), 1019-1025 [10.1007/s40620-020-00706-3].
Binda, V; Trezzi, B; Del Papa, N; Beretta, L; Frontini, G; Porata, G; Fabbrini, P; Pozzi, M; Messa, P; Sinico, R; Moroni, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/259824
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