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Efficacy and safety of telitacicept in patients with lupus nephritis: a single-center, real-world retrospective study

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Abstract

Background

Telitacicept, an innovative drug used for the treatment of systemic lupus erythematosus (SLE), can effectively control disease progression and achieve favorable outcomes. While case reports have mentioned the use of Telitacicept in lupus nephritis (LN) treatment, its safety and efficacy in treating patients with LN have not been explored. Therefore, in this study, we aimed to evaluate the safety and efficacy of Telitacicept in managing patients with LN.

Methods

In a single-center, real-world retrospective study, 30 LN patients with poor response or adverse reactions to conventional glucocorticoids at our Hospital were enrolled to receive Telitacicept. Patients were administered 160 mg of Telitacicept subcutaneously once a week for at least 24 weeks in addition to standard treatment. We assessed the SLE responder index-4 (SRI-4) at the beginning and the end of the treatment period, measured laboratory test indicators at 3, 6, and 9 months, and observed the occurrence of adverse events in these patients.

Results

The SRI-4 response rate was 86.67% (n = 26), with a significantly lower systemic lupus erythematosus disease activity index (SLEDAI) score compared to the baseline. Post Telitacicept treatment, glucocorticoid intake of patients with LN significantly reduced from 50 (IQR:40, 51.25) at baseline to 10 (IQR:5,10) at the endpoint (Z = − 6.547, p < 0.001). Patients with LN showed significantly improved urine occult blood levels after Telitacicept therapy. While the complement (C3 and C4) contents increased, immunoglobulins (IgG, IgA and IgM) reduced markedly (p < 0.001). The negative rate of dsDNA reached 26.67% and adverse events were alleviated post treatment. Only two cases of LN-related adverse reactions were reported, including herpes and infectious fever, respectively. Telitacicept primarily serves as an agent for the induction of remission therapy, with an attainment of complete remission rate standing at a commendable 73.3%.

Conclusions

Telitacicept treatment reduced disease severity in patients with LN. The initial clinical trial provided supportive evidence for the effectiveness and safety of Telitacicept as a viable treatment option for LN, allowing a reduction in the daily glucocorticoid intake while maintaining a good safety profile, and improving hypocomplementation in LN management.

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Funding

This work was financially supported by Qihang Project of Fujian Medical University (2020QH1282).

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Authors and Affiliations

  1. Department of Rheumatology, Zhangzhou Affiliated Hospital of Fujian Medical University, No.59 Shengli West Road, Xiangcheng District, Zhangzhou, 363000, Fujian Province, China

    Xiaolu Huang, Fuan Lin & Hongpu Chen

Authors
  1. Xiaolu Huang
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  2. Fuan Lin
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  3. Hongpu Chen
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Contributions

Hongpu Chen designed the study. Xiaolu Huang and Hongpu Chen supervised the project. Xiaolu Huang collected data. Xiaolu Huang, Fuan Lin and Hongpu Chen performed the data analysis and wrote the manuscript. Hongpu Chen reviewed the manuscript.

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Correspondence to Hongpu Chen.

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Huang, X., Lin, F. & Chen, H. Efficacy and safety of telitacicept in patients with lupus nephritis: a single-center, real-world retrospective study. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02501-x

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