A CASE REPORT OF TELITACICEPT IN THE TREATMENT OF IMMUNOCOMPROMISED AND REFRACTORY LUPUS NEPHRITIS

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A CASE REPORT OF TELITACICEPT IN THE TREATMENT OF IMMUNOCOMPROMISED AND REFRACTORY LUPUS NEPHRITIS

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Co-author 1

Yongda Lin 983003488@qq.com the Second Affiliated Hospital of Shantou University Department of Nephrology shantou China -

Co-author 2

Chunling Liao 19clliao@stu.edu.cn the Second Affiliated Hospital of Shantou University Department of Nephrology shantou China -

Co-author 3

Zhensheng Yang yzs2005@126.com the Second Affiliated Hospital of Shantou University Department of Nephrology shantou China -

Co-author 4

Tianbiao Zhou 13670402516@163.com the Second Affiliated Hospital of Shantou University Department of Nephrology shantou China *

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Introduction

Lupus nephritis (LN) is a severe manifestation of kidney involvement in systemic lupus erythematosus (SLE), particularly common among Asian populations. The standard of care (SOC) includes antimalarials, glucocorticoids, and immunosuppressants. However, treatment failure and infection-related complications remain major challenges. Telitacicept, a novel biologic targeting BLyS and APRIL, may offer an alternative option for refractory LN.

Methods

We report a 29-year-old woman with a 15-year history of LN who experienced multiple relapses and recurrent severe pulmonary infections after SOC therapy. Following anti-infective treatment, an individualized regimen combining low-dose glucocorticoids with telitacicept (80–160 mg, weekly) was introduced according to her immunologic status. Clinical and laboratory parameters were monitored regularly.

Results

After six weeks of therapy, urinary protein/creatinine ratio decreased significantly from 15,455 mg/g to 1,403 mg/g, reaching complete remission by week 12. No infectious complications occurred during treatment, and glucocorticoid dosage was successfully reduced from 36 mg/day to 4 mg every other day. The patient maintained stable renal function and remission during one-year follow-up.

Conclusion

Individualized therapy combining telitacicept with low-dose glucocorticoids achieved rapid and sustained remission in an immunocompromised patient with refractory LN. This case suggests that telitacicept may be a safe and effective treatment option for patients intolerant or unresponsive to conventional immunosuppressive regimens.

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