Abstract: SA-PO0807
Belimumab for Advanced Lupus Nephritis (CKD Stages 3-5): Efficacy and Safety from a Real-World Cohort
Session Information
- Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Jiao, Yuhan, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- Xing, Guangqun, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
Group or Team Name
- Renal division, the Affiliated hospital of Qingdao University
Background
To evaluate the efficacy and safety of belimumab in the treatment of patients with chronic kidney disease (CKD) stages 3-5 lupus nephritis (LN) in a real-world setting.
Methods
Patients with CKD stages 3-5 LN treated at the Department of Nephrology, the Affiliated Hospital of Qingdao University, from November 2023 to April 2025 were prospectively enrolled. Those receiving belimumab plus conventional therapy were assigned to the belimumab group, while those receiving conventional therapy alone were assigned to the conventional therapy group. Patients with CKD stages 3-5 LN who received conventional therapy at our hospital from January 2022 to October 2023 were retrospectively identified and supplemented into the conventional therapy group. Propensity score matching (PSM) was performed at a 1:2 ratio, and all patients were followed up for at least 3 months. The therapeutic effects and adverse events of the two matched groups were evaluated.
Results
After matching, 56 patients were included (19 belimumab, 37 conventional). Median follow-up was 12 (4–16) and 12 (6–19) months, respectively. At last follow-up, eGFR in the belimumab group increased from 23.14±16.35 to 28.04±19.90 mL/min (P>0.05), but decreased in the conventional group (23.76±17.06 to 17.64±15.68; P=0.001). The annual eGFR slope was significantly better with belimumab (+5 vs. –4.37 mL/min/year; P=0.003). Belimumab also significantly improved C3/C4, ANA titer, albumin, UACR, 24-h proteinuria, SLEDAI-2000, and mean daily prednisone dose (all adjusted P<0.05), while no changes occurred in the conventional group (adjusted P>0.05). Adverse event rates were similar (73.7% vs. 70.3%; P>0.05), and CMV and fungal infections did not differ (both P>0.05).
Conclusion
In patients with CKD stages 3-5 LN, belimumab combined with conventional therapy may help delay the progressive decline in renal function, suppress disease activity, reduce glucocorticoid dosage, and demonstrate a favorable safety profile.