The effect analysis of early application of belimumab in the treatment of patients with systemic lupus erythematosus and its impact on hormone reduction
Objective To observe the effects of early application(within 3 months of induced remission)of belimumab in the treatment of systemic lupus erythematosus(SLE)and its impact on hormone reduction.Results 83 SLE patients treated with belimumab was selected,and methylprednisolone and mycophenolate mofetil were used as background drugs in both groups.The patients were divided into early group(35 cases)and control group(48 cases)based on the time they began using belimumab during the induced remission period.Patients in the early group started using belimumab after an induced remission period of≤3 months,and patients in the control group started using belimumab after an induced remission period of＞3 months.Both groups were compared in terms of blood routine indexes[white blood cell count(WBC),neutrophil count(Neut),lymphocyte count(Lym),platelet count(PLT),hemoglobin(Hb)],liver and kidney function indexes[albumin(ALB),serum creatinine(SCr)],erythrocyte sedimentation rate(ESR)levels,immune function indexes[immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),globulin,complement C3,complement C4],hormone reduction,Systemic Lupus Erythematosus Disease Activity Index(SLEDAI-2000 score)and major organ damage.Results At 24 weeks of treatment,Neut of(4.39±1.59)×109/L in the early group was obviously lower than(6.56±3.09)×109/L in the control group;Lym and Hb were(1.73±0.49)×109/L and(122.85±15.38)g/L at 12 weeks of treatment,and(1.59±0.49)×109/L and(123.20±16.70)g/L at 24 weeks of treatment,which were significantly higher than(1.48±0.42)×109/L,(105.89±16.91)g/L and(1.38±0.34)×109/L,(103.42±25.63)g/L in the control group;there was statistical difference(P＜0.05).In early group,ALB level of(41.20±3.07)g/L at 24 weeks of treatment was significantly higher than(38.50±6.06)g/L in the control group;SCr level was(55.46±16.40)μmol/L at 12 weeks of treatment and(54.79±16.15)μmol/L at 24 weeks of treatment,which were significantly lower than(74.46±24.21)and(69.34±20.95)μmol/L in the control group;ESR level of(24.44±10.63)mm/h at 12 weeks of treatment was significantly lower than(32.37±11.21)mm/h in the control group;there was statistical difference(P＜0.05).The IgG and IgA levels in the early group at 12 and 24 weeks of treatment were significantly lower than those in the control group,the globulin level at 12 weeks of treatment were significantly lower than that in the control group,and the C3 levels at 12 and 24 weeks of treatment were significantly higher than those in the control group.There was statistical difference(P＜0.05).At 12 and 24 weeks of treatment,the hormone reduction were(60.49±27.42)and(68.23±22.12)mg in the early group,which were significantly higher than(21.00±6.96)and(28.37±7.60)mg in the control group;SLEDAI-2000 score were(3.77±1.06)and(2.74±0.44)points,which were significantly lower than(4.79±1.46)and(2.96±0.40)points in the control group;there was statistical difference(P＜0.05).There was no significant difference in the incidence of major organ damage between the two groups(P＞0.05).Conclusion Early application of belimumab in the treatment of patients with SLE can improve anemia,liver and kidney function,ESR,and immune function,which is conducive to faster reduction of hormone dosage and does not increase the risk of major organ damage.
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