Department of Rheumatology, Zhongshan Hospital Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
Clin Rheumatol. 2024 Aug;43(8):2513-2520. doi: 10.1007/s10067-024-07029-9. Epub 2024 Jun 14.
This study is asked to investigate the effects of belimumab on the lipid profile in systemic lupus erythematosus (SLE) patients. Forty-one SLE patients who received at least 6 months of belimumab treatment were retrospectively analyzed. The control group consisted of 56 age- and sex-matched lupus patients not treated with belimumab. The changes in lipid profile after a 6-month treatment were compared between the two groups. Generalized estimating equation (GEE) analyses were performed to examine lipid levels longitudinally during the period and the effect of clinical response variables and medication on the lipid profile in the belimumab group. In the belimumab group, high-density lipoprotein (HDL) cholesterol levels increased significantly after the 6-month treatment (P = 0.02). After 1 month, HDL, apolipoprotein A-I (apoA-I) significantly increased by 13.8 and 11.4%, compared with baseline, respectively. After 3 months, HDL and apoA-I increased by 9.0 and 7.1%, respectively. After 6 months, HDL increased by 7.6% compared with baseline. Total cholesterol, triglycerides, low-density lipoprotein cholesterol, and apolipoprotein B did not change significantly over the course of treatment. GEE analyses indicated a significant association between HDL and disease activity indexes, such as IgG, anti-dsDNA, and complement C3. Subgroup analysis revealed significant changes in HDL only in patients who had achieved a ≥ 4-point reduction in SLEDAI-2 K after 6 months of belimumab treatment. Belimumab treatment may result in a long-term increase in HDL level in SLE patients by improving control of lupus activity. This might have beneficial effects on controlling cardiovascular risk in lupus patients. Key Points • Treatment with belimumab resulted in a significant and sustained increase in the HDL levels in SLE patients. • Significant changes in HDL were observed in lupus patients treated with belimumab who had a better clinical response.
这项研究旨在探讨贝利尤单抗对系统性红斑狼疮（SLE）患者血脂谱的影响。回顾性分析了 41 例接受贝利尤单抗治疗至少 6 个月的 SLE 患者。对照组由 56 例年龄和性别匹配的未接受贝利尤单抗治疗的狼疮患者组成。比较两组患者治疗 6 个月后血脂谱的变化。采用广义估计方程（GEE）分析在研究期间纵向检查血脂水平，并分析贝利尤单抗组中临床反应变量和药物对血脂谱的影响。在贝利尤单抗组中，治疗 6 个月后高密度脂蛋白（HDL）胆固醇水平显著升高（P=0.02）。治疗 1 个月后，HDL 和载脂蛋白 A-I（apoA-I）分别比基线增加了 13.8%和 11.4%。治疗 3 个月后，HDL 和 apoA-I 分别增加了 9.0%和 7.1%。治疗 6 个月后，HDL 比基线增加了 7.6%。在整个治疗过程中，总胆固醇、甘油三酯、低密度脂蛋白胆固醇和载脂蛋白 B 没有显著变化。GEE 分析表明，HDL 与 IgG、抗 dsDNA 和补体 C3 等疾病活动指标之间存在显著相关性。亚组分析显示，仅在治疗 6 个月后 SLEDAI-2K 下降≥4 分的患者中，HDL 有显著变化。贝利尤单抗治疗可能通过改善狼疮活动的控制，导致 SLE 患者的 HDL 水平长期升高。这可能对控制狼疮患者的心血管风险有有益影响。重点 • 贝利尤单抗治疗可显著持续增加 SLE 患者的 HDL 水平。 • 在接受贝利尤单抗治疗且临床反应较好的狼疮患者中观察到 HDL 显著变化。
