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Abstract: FR-PO623

Belimumab and Multitarget Therapy, Mycophenolate Mofetil, and Tacrolimus as Induction Therapy of Severe Active Lupus Nephritis: Case Series From China

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Min, Min, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing Medical University, Nanjing, China
  • Zhang, Jiong, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
Introduction

To assess safety and generate preliminary efficacy data on multitarget therapy (MT) and standard care followed by belimumab (BLM) for severe active Chinese LN patients, a case series were investigated.

Four patients with severe active LN were treated with standard care [mycophenolate mofetil (MMF) / tacrolimus (FK506)]or MT, followed by BLM infusions. BLM were given 10mg/kg every 2 weeks for 3 times, then every 4 weeks till Week 24. Primary renal response index, SLEDAI and safety data were analyzed.

Case Description

The patients (3 females) affected by LN ISN/RNP Class III/IV±V with high disease activity are 2 de no LN, 2 refractory LN. At baseline, the SLEDAI score were 20,17,16,15 respectively. Three of them accepted intravenous (IV) methylprednisolone, followed by standard care or MT, one patient started standard care immediately after admission. Within 2 weeks of starting treatment, IV BLM was introduced. The initial oral prednisone doses were 30-45mg/day. At Week 24, the SLEDAI score decreased to 2,8,10,2 respectively. Two patients who accepted MT achieved complete renal remission,the other two achieved partial renal remission (Figure 1). MT and BLM therapy reduced SLEDAI more rapidly than MMF or FK506 regimen (Figure 2). Prednisone reduced to 10-15mg/day. No adverse events occurred.

Discussion

The addition of belimumab to MT or standard therapy was safe . This regimen leads to renal remission in severe active LN patients and diminishes SLEDAI. Further studies are needed to evaluate the benefits of belimumab combined with MT in severe active LN.