All 7 patients had biopsy-proven LN (class IV±V), including 4 newly diagnosed cases, 1
relapsed case (all with massive proteinuria), and 2 treated patients who
achieved partial remission after 6 months of belimumab treatment and were
switched to telitacicept. All patients completed ≥32 weeks of
telitacicept treatment. The median age was 35 years, with a male-to-female
ratio of 1:6. Four newly diagnosed patients and 1 relapsed patient received
methylprednisolone pulse therapy during the induction phase. All patients
received hormone + mycophenolate mofetil treatment, and the initial dose of
telitacicept was 160mg/week.
1.
Urinary
protein and albumin:
The
24-hour urinary protein decreased from 2.67±2.77g at
baseline to 1.11±0.47g at 8 weeks (58.42% reduction from
baseline), 0.64±0.36g at 16 weeks (76.03% reduction), and
0.36±0.28g at 32 weeks (86.52% reduction,
P=0.006) after telitacicept treatment. The baseline serum albumin was 34.52±9.42g/L, which increased to 38.43±5.57g/L at 8 weeks (11.33% increase), 39.83±5.11g/L at 16 weeks (15.38% increase), and
43.50±3.26g/L at 32 weeks (26.01% increase).
2.
Renal
function:
The serum creatinine levels at baseline, 8,
16, and 32 weeks after telitacicept treatment were 59±7.53μmol/L, 55.4±7.96μmol/L, 51.83±8.47μmol/L, and 53.83±10.7μmol/L,
respectively, with no significant differences.
3.
Immune
indicators:
The
baseline complement C3 and C4 levels were 0.69±0.26g/L and 0.18±0.07g/L, respectively. At 8 weeks of
treatment, they were 0.83±0.25g/L and 0.22±0.08g/L; at 16 weeks, 0.97±0.06g/L and 0.24±0.04g/L; and at 32 weeks, 1.01±0.11g/L (P=0.025) and 0.26±0.04g/L (P=0.029), respectively, showing
significant increases.
4.
Renal
remission:
At 16
weeks of telitacicept treatment, 3 newly diagnosed patients achieved complete
remission (CR) and 4 achieved partial remission (PR). At 32 weeks, 4 newly
diagnosed patients and 1 treated patient achieved CR, and 1 relapsed patient
and 1 treated patient achieved PR, with an overall remission rate of 100%.
5.
Adverse
events:
Telitacicept
was well-tolerated during treatment. One patient developed an upper respiratory
tract infection, which improved after outpatient treatment, with no serious
adverse events.
