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对36名以色列系统性红斑狼疮患者进行抗B淋巴细胞刺激因子治疗。

Anti-BLyS Treatment of 36 Israeli Systemic Lupus Erythematosus Patients.

作者信息

Sthoeger Zev, Lorber Margalit, Tal Yuval, Toubi Elias, Amital Howard, Kivity Shaye, Langevitz Pnina, Asher Ilan, Elbirt Daniel, Agmon Levin Nancy

机构信息

Department of Internal Medicine B and Clinical Immunology, Allergy and Neve-Or AIDS Center, Kaplan Medical Center, Rehovot, Israel.

Allergy and Clinical Immunology Unit, Rambam Medical Center, Haifa, Israel.

出版信息

Isr Med Assoc J. 2017 Jan;19(1):44-48.

Abstract

BACKGROUND

Anti-BLyS treatment with the human belimumab monoclonal antibody was shown to be a safe and effective therapeutic modality in lupus patients with active disease (i.e., without significant neurological/renal involvement) despite standard treatment.

OBJECTIVES

To evaluate the "real-life" safety and efficacy of belimumab added to standard therapy in patents with active lupus in five Israeli medical centers.

METHODS

We conducted a retrospective open-labeled study of 36 lupus patients who received belimumab monthly for at least 1 year in addition to standard treatment. Laboratory tests (C3/C4, anti dsDNA autoantibodies, chemistry, urinalysis and complete blood count) were done every 3-4 months. Adverse events were obtained from patients' medical records. Efficacy assessment by the treating physicians was defined as excellent, good/partial, or no response.

RESULTS

The study group comprised 36 lupus patients (8 males, 28 females) with a mean age of 41.6 } 12.2 years. Belimumab was given for a mean period of 2.3 } 1.7 years (range 1-7). None of the patients discontinued belimumab due to adverse events. Four patients (11.1%) had an infection related to belimumab. Only 5 patients (13.9%) stopped taking belimumab due to lack of efficacy. The response was excellent in 25 patients (69.5%) and good/partial in the other 6 (16.6%). Concomitantly, serological response (reduction of C3/C4 and anti-dsDNA autoantibodies) was also observed. Moreover, following belimumab treatment, there was a significant reduction in the usage of corticosteroids (from 100% to 27.7%) and immunosuppressive agents (from 83.3% to 8.3%).

CONCLUSIONS

Belimumab, in addition to standard therapy, is a safe and effective treatment for active lupus patients.

摘要

背景

在狼疮患者(即无明显神经/肾脏受累)中,尽管接受了标准治疗,但使用人贝利木单抗单克隆抗体进行抗BLyS治疗被证明是一种安全有效的治疗方式。

目的

评估在以色列五个医疗中心中,将贝利木单抗添加到标准治疗方案中对活动性狼疮患者的“实际生活”安全性和有效性。

方法

我们对36例狼疮患者进行了一项回顾性开放标签研究,这些患者除标准治疗外,每月接受贝利木单抗治疗至少1年。每3 - 4个月进行实验室检查(C3/C4、抗双链DNA自身抗体、化学检查、尿液分析和全血细胞计数)。不良事件来自患者的病历。治疗医生的疗效评估定义为优、良/部分缓解或无反应。

结果

研究组包括36例狼疮患者(8例男性,28例女性),平均年龄为41.6 ± 12.2岁。贝利木单抗的平均给药时间为2.3 ± 1.7年(范围1 - 7年)。没有患者因不良事件停用贝利木单抗。4例患者(11.1%)发生了与贝利木单抗相关的感染。仅5例患者(13.9%)因缺乏疗效而停止服用贝利木单抗。25例患者(69.5%)反应为优,另外6例(16.6%)为良/部分缓解。同时,还观察到血清学反应(C3/C4和抗双链DNA自身抗体降低)。此外,在贝利木单抗治疗后,皮质类固醇的使用量显著减少(从100%降至27.7%),免疫抑制剂的使用量也显著减少(从83.3%降至8.3%)。

结论

除标准治疗外,贝利木单抗对活动性狼疮患者是一种安全有效的治疗方法。

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