Wei Si-Ru, Zhu Zhen-Zhen, Xu Jia, Mo Han-You
Department of Rheumatology, Guilin Medical University, Guilin, China.
Department of Rheumatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Int J Rheum Dis. 2023 Jan;26(1):154-156. doi: 10.1111/1756-185X.14445. Epub 2022 Sep 27.
Systemic lupus erythematosus (SLE) is associated with poor pregnancy outcomes and complications. Belimumab can significantly improve disease activity in patients with SLE. However, there is insufficient evidence to prove the absolute safety of belimumab treatment during pregnancy.
A 37-year-old woman was diagnosed with SLE after a renal puncture biopsy in 2012. The other patient was a 25-year-old woman. She was diagnosed with SLE at 19 years of age. They were treated by standard therapy in the early stage of treatment. The first patient has multiple histories of miscarriages or abortions at different gestational ages caused by SLE activity. The other patient also has persistent thrombocytopenia due to SLE flare. In our patients, SLE was poorly controlled by standard therapy. We initiated belimumab treatment during pregnancy because the benefits of treating SLE outweighed the risks to the fetus. The first patient was admitted to the first belimumab infusion at approximately 14 weeks of gestation. The other patient was admitted to the first belimumab infusion at approximately 12 weeks of gestation. Although our patients did not show complete disease remission during belimumab treatment, neither had serious adverse reactions or adverse pregnancy events, and their babies were in good conditions at birth.
We present 2 cases of pregnant women with SLE who were treated with belimumab. Both were able to deliver their babies successfully without any complications.
系统性红斑狼疮(SLE)与不良妊娠结局及并发症相关。贝利尤单抗可显著改善SLE患者的疾病活动度。然而,尚无足够证据证明贝利尤单抗在孕期治疗的绝对安全性。
一名37岁女性于2012年经肾穿刺活检确诊为SLE。另一名患者为25岁女性,19岁时被诊断为SLE。她们在治疗初期接受标准治疗。第一名患者因SLE活动在不同孕周有多次流产或堕胎史。另一名患者也因SLE病情复发出现持续性血小板减少。在我们的患者中,标准治疗对SLE的控制不佳。由于治疗SLE的益处大于对胎儿的风险,我们在孕期开始使用贝利尤单抗治疗。第一名患者在妊娠约14周时首次接受贝利尤单抗输注。另一名患者在妊娠约12周时首次接受贝利尤单抗输注。尽管我们的患者在贝利尤单抗治疗期间未实现疾病完全缓解,但均未出现严重不良反应或不良妊娠事件,且她们的婴儿出生时状况良好。
我们报告了2例接受贝利尤单抗治疗的SLE孕妇病例。两人均成功分娩,无任何并发症。