Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus

ZHAO Yuanxia; GAO Guanmin; LU Xiaojing; CHU Yaojuan; WANG Song; SHI Xiangfen; DU Shuzhang; ZHANG Xiaojian

doi:10.6039/j.issn.1001-0408.2023.07.15

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Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus

更新时间：2024-02-19

- Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus
- ZHONGGUO YAOFANG Vol. 34, Issue 7, Pages: 849-853(2023)
- 作者机构：
  
  1.郑州大学第一附属医院药学部，郑州　450052
  2.郑州大学第一附属医院风湿免疫科，郑州　450052
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.07.15
  CLC： R593.24;R969.3
- Published：15 April 2023，
  
  Received：26 November 2022，
  
  Revised：29 December 2022，
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赵院霞,高冠民,卢晓静等.9例利妥昔单抗序贯贝利尤单抗治疗重症系统性红斑狼疮的临床观察 ^Δ[J].中国药房,2023,34(07):849-853.

ZHAO Yuanxia,GAO Guanmin,LU Xiaojing,et al.Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus[J].ZHONGGUO YAOFANG,2023,34(07):849-853.
赵院霞,高冠民,卢晓静等.9例利妥昔单抗序贯贝利尤单抗治疗重症系统性红斑狼疮的临床观察 ^Δ[J].中国药房,2023,34(07):849-853. DOI： 10.6039/j.issn.1001-0408.2023.07.15.

ZHAO Yuanxia,GAO Guanmin,LU Xiaojing,et al.Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus[J].ZHONGGUO YAOFANG,2023,34(07):849-853. DOI： 10.6039/j.issn.1001-0408.2023.07.15.

摘要

目的

探讨利妥昔单抗（RTX）序贯贝利尤单抗（BLM）在重症系统性红斑狼疮（SSLE）患者中的临床疗效与安全性。

方法

纳入2020年10月至2021年6月郑州大学第一附属医院风湿免疫科使用RTX序贯BLM治疗6个月以上的SSLE患者9例，回顾性收集患者的基线临床资料，用药第0、4、12、24周的实验室检查结果和基础治疗情况。分析患者系统性红斑狼疮疾病活动度指数（SLEDAI）评分、糖皮质激素用量和血清学指标（补体C3、补体C4、血清白蛋白和24 h尿蛋白定量）水平；同时收集患者不良反应发生情况。

结果

9例患者均完成超过24周的RTX序贯BLM药物治疗，所有患者均有肾脏损伤，其中7例（77.8%）有肾脏病理学支持，3例（33.3%）合并血液系统损伤，2例（22.2%）合并神经系统损伤。治疗期间，随着治疗时间的延长，患者的SLEDAI评分、24 h尿蛋白定量、糖皮质激素用量均呈显著的下降趋势，最终下降至正常指标水平（

＜0.05）；血清白蛋白、补体C3、补体C4均呈显著的升高趋势，最终升高至正常指标水平（

＜0.05）。在治疗及随访过程中，1例患者出现带状疱疹，1例患者出现上呼吸道病毒感染，1例患者出现泌尿系统细菌感染，给予对症处理后均痊愈。

结论

RTX序贯BLM治疗SSLE，早期给予RTX能快速稳定病情，使患者临床症状明显减轻，特异性血清学指标逐步趋于正常；后续给予BLM可减少基础治疗药物的种类和用量；同时未增加不良反应。

Abstract

OBJECTIVE

To investigate the clinical efficacy and safety of rituximab （RTX） followed by belimumab （BLM） in patients with severe systemic lupus erythematosus（SSLE）.

METHODS

Nine SSLE patients， who were treated with RTX followed by BLM for more than 6 months in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Zhengzhou University from October 2020 to June 2021， were enrolled. Baseline clinical data of patients， laboratory examination results and basic treatment status at weeks 0， 4， 12， and 24 of medication were collected retrospectively. The patients’ systemic lupus erythematosus disease activity index （SLEDAI） score， glucocorticoid dosage and serological indicators （complement C3， complement C4， serum albumin， and 24-hour urine protein quantification） level were analyzed. At the same time， the occurrence of adverse drug reaction was collected.

RESULTS

All 9 patients completed more than 24 weeks of RTX followed by BLM therapy. All patients suffered from renal impairment， of which 7 （77.8%） had renal pathology support， 3（33.3%） had blood system damage and 2 （22.2%） had nervous system damage. During treatment， with the prolongation of treatment time， the SLEDAI score， 24-hour urinary protein quantification， and glucocorticoid dosage of patients showed a significant downward trend， and ultimately decreased to the normal index level （

＜0.05）； serum albumin， complement C3 and complement C4 all showed a significant upward trend， eventually rose to the normal index level （

＜0.05）. During treatment and follow-up， 1 patient developed herpes zoster， 1 patient developed upper respiratory tract virus infection， and 1 patient developed urinary system bacterial infection. All patients recovered after symptomatic treatment.

CONCLUSIONS

In sequential use of RTX followed by BLM for SSLE， early administration of RTX can quickly stabilize the condition， significantly alleviate clinical symptoms， and gradually normalize specific serological indicators； subsequent administration of BLM can reduce the type and dosage of basic treatment drugs； there is no increase in the incidence of adverse drug reactions.

关键词

贝利尤单抗利妥昔单抗重症系统性红斑狼疮临床疗效安全性

Keywords

rituximabsevere systemic lupus erythematosusclinical efficacysafety

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