Sthoeger Zev, Lorber Margalit, Tal Yuval, Toubi Elias, Amital Howard, Kivity Shaye, Langevitz Pnina, Asher Ilan, Elbirt Daniel, Agmon Levin Nancy
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.
Isr Med Assoc J. 2017 Jan;19(1):44-48.
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.
To evaluate the "real-life" safety and efficacy of belimumab added to standard therapy in patents with active lupus in five Israeli medical centers.
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.
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%).
Belimumab, in addition to standard therapy, is a safe and effective treatment for active lupus patients.
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。
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。
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。
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%)。
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。