Belimumab Is Safe, Effective in Patients With Refractory Lupus Nephritis

Adding belimumab to a treatment regimen of rituximab and cyclophosphamide is safe and effective in patients with refractory lupus nephritis (LN), according to the results of a recent study.

The researchers conducted a multicenter, randomized, open-label clinical trial involving 43 patients with recurrent or refractory LN who were treated with either rituximab, CYC, and glucocorticoids followed by weekly belimumab or with rituximab and CYC and no belimumab.

Overall, treatment with belimumab was not associated with an increased risk of adverse events and a complete or partial renal response was observed in 11 (52%) of 21 patients who received belimumab compared with 9 (41%) of 22 patients who did not.

Further, B cell depletion was observed in both groups, but the percentage of B cells was lower among participants receiving belimumab.

“The addition of belimumab to a treatment regimen with rituximab and CYC was safe in patients with refractory LN. This regimen diminished maturation of transitional to naive B cells during B cell reconstitution and enhanced the negative selection of autoreactive B cells. Clinical efficacy was not improved with rituximab and CYC in combination with belimumab when compared to a therapeutic strategy of B cell depletion alone in patients with LN,” the researchers concluded.

—Michael Potts

Reference:

Atisha-Fregoso Y, Malkiel S, Harris KM, et al. Phase II randomized trial of rituximab plus cyclophosphamide followed by belimumab for the treatment of lupus nephritis. Arthritis Rheumatol. 2021. 73(1):121-131. doi: 10.1002/art.41466.