The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Int J Rheum Dis. 2023 Jul;26(7):1417-1421. doi: 10.1111/1756-185X.14752. Epub 2023 May 23.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Lupus nephritis (LN) is a common type of organ damage which occurs in SLE patients and is characterized by recurrent proteinuria. Activation of B lymphocytes can lead to refractory LN, which is an important pathogenic factor in SLE. B lymphocyte stimulator (BLyS) and A proliferation-inducing ligand (APRIL) are predominantly produced by myeloid cells (monocytes, dendritic cells, neutrophils, etc) to regulate B lymphocyte function. Telitacicept was the first dual-targeting biological drug which targeted both BLyS and APRIL. Telitacicept has passed a phase II clinical trial and has since been approved for the treatment of SLE.
We report a case of SLE confirmed by renal biopsy as proliferative lupus nephritis (PLN) with massive proteinuria, which was treated with telitacicept (European League Against Rheumatism / American College of Rheumatology 2019 standard). During the 19 months of follow-up, the patient's renal function was stable, massive proteinuria was relieved, and creatinine and blood pressure did not increase.
During the 19 months of telitacicept treatment (160 mg once weekly), PLN reduced blood system damage and proteinuria without increasing the risk of infection.
系统性红斑狼疮(SLE)是一种慢性自身免疫性疾病。狼疮肾炎(LN)是一种常见的器官损伤类型,发生在 SLE 患者中,其特征是复发性蛋白尿。B 淋巴细胞的激活可导致难治性 LN,这是 SLE 的一个重要发病因素。B 淋巴细胞刺激因子(BLyS)和增殖诱导配体(APRIL)主要由髓样细胞(单核细胞、树突状细胞、中性粒细胞等)产生,以调节 B 淋巴细胞的功能。Telitacicept 是首个靶向 BLyS 和 APRIL 的双靶点生物药物。Telitacicept 已通过 II 期临床试验,并已获准用于治疗 SLE。
我们报告了一例经肾活检证实为增生性狼疮肾炎(PLN)伴大量蛋白尿的 SLE 病例,采用 Telitacicept(欧洲抗风湿病联盟/美国风湿病学会 2019 标准)治疗。在 19 个月的随访期间,患者肾功能稳定,大量蛋白尿缓解,肌酐和血压未升高。
在 19 个月的 Telitacicept 治疗(每周 160mg 一次)期间,PLN 减少了血液系统损伤和蛋白尿,而没有增加感染的风险。