首页|贝利木单抗治疗系统性红斑狼疮的临床观察

贝利木单抗治疗系统性红斑狼疮的临床观察

Clinical observations in the treatment of systemic lupus erythematosus with belimumab

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目的 探索贝利木单抗治疗系统性红斑狼疮(SLE)的有效性和安全性.方法 收集北京协和医院自2020年5月1日起至2022年2月1日期间使用贝利木单抗的SLE患者.利用Mann-Whitney U检验和t检验分析患者加用贝利木单抗前后的临床表现、SLEDAI-2000评分、实验室检查结果及不良反应.结果 81例患者纳入本研究,在免疫抑制剂药物用量不变的基础上,加用贝利木单抗可以明显降低SLE患者的 SLEDAI-2000 评分[10.00(7.75,12.00)分与 4.00(3.75,6.00)分,Z=-5.38,P<0.001],ESR[19.50(12.75,32.25)mm/1 h 与 14.00(7.75,20.25)mm/1 h,Z=-3.71,P=0.003];抗 dsDNA抗体滴度[300.00(117.00,864.00)与183.00(100.00,471.00),Z=-4.68,P=0.001];同时补体升高 C3[0.78(0.62,0.97)g/L 与 0.69(0.55,0.84)g/L,Z=-4.68,P<0.001];补体 C4[0.12(0.08,0.19)g/L 与 0.10(0.05,0.14)g/L,Z=-4.78,P<0.001];降低患者糖皮质激素(激素)使用量[10.00(7.50,22.50)mg 与 7.50(5.00,10.00)mg,Z=-4.90,P<0.001].另外,患者的IgG、IgA、IgM明显下降,但1例患者因免疫球蛋白过低停药.结论 贝利木单抗可以缓解SLE患者疾病活动度,减少激素的用量,且耐受性良好.
Objective To further investigate the safety and efficacy of Belimumab in the treatment of patients with systemic lupus erythematosus(SLE).Methods All SLE patients treated with Belimumab from May 1,2020 to February 1,2022 in Peking Union Medical College Hospital were retrospectively collected and analyzed.The clinical manifestations,the Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2000)score,and laboratory test such as levels of anti-dsDNA antibody,the medication before and after Belimumab treatment,adverse events were collected.Normally distributed data were tested using the t-test,otherwise the Wilcoxon paired signed rank test was used.Results A total of 81 patients were enrolled in this study.The use of belimumab could significantly decrease the SLEDAI-2000 score[10.00(7.75,12.00)vs.4.00(3.75,6.00),Z=-5.38,P<0.001],ESR of SLE patients[19.50(12.75,32.25)mm/1 h vs.14.00(7.75,20.25)mm/1 h,Z=-3.71,P=0.003],anti-dsDNA titer detected by CLIFT[300.00(117.00,864.00)vs.183.00(100.00,471.00),Z=-4.15,P=0.001],meanwhile,increase the complement C3[0.78(0.62,0.97)g/L vs.0.69(0.55,0.84)g/L,Z=-4.68,P<0.001],and the complement C4[0.12(0.08,0.19)g/L vs.0.10(0.05,0.14)g/L,Z=-4.78,P<0.001].We also observed that with the use of Belimumab,the dosage of Glucocorticoids decreased significantly,which were[10.00(7.50,22.50)mg vs.7.50(5.00,10.00)mg,Z=-4.90,P<0.001].In addition,the antibody of IgG,IgA and IgM decreased significantly.Only one patient stopped the administration of Belimumab due to the low level of immunoglobulin.Conclusion Belimumab can alleviate disease activity of patients with SLE and help in safely tapering the daily dose of glucocorticoid with good safety.

Lupus erythematosus,systemicGlucocorticoidsBelimumab

李鹏冲、阙咏图、吴迪、赵丽丹、周佳鑫、杨华夏、王立、彭琳一、刘金晶、张奉春

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中国医学科学院北京协和医院风湿免疫科 风湿免疫学教育部重点实验室 国家皮肤与免疫疾病临床医学研究中心,北京 100370

东莞康华医院风湿免疫科,东莞 523000

红斑狼疮,系统性 糖皮质激素类 贝利木单抗

2024

中华风湿病学杂志
中华医学会

中华风湿病学杂志

CSTPCD
影响因子:0.651
ISSN:1007-7480
年,卷(期):2024.28(9)
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