Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study

Abstract Objective In this study, we performed a meta‐analysis and a propensity score‐matched case–control study to evaluate the efficacy and safety of belimumab in patients with lupus nephritis (LN). Methods We analyzed the data from three randomized controlled trials (RCTs) to assess the effects o...

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Main Authors: Kai Zhang, Tiening Qi, Donghua Guo, Youxia Liu
Format: Article
Language:English
Published: Wiley 2023-07-01
Series:Immunity, Inflammation and Disease
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Online Access:https://doi.org/10.1002/iid3.954
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author Kai Zhang
Tiening Qi
Donghua Guo
Youxia Liu
author_facet Kai Zhang
Tiening Qi
Donghua Guo
Youxia Liu
author_sort Kai Zhang
collection DOAJ
description Abstract Objective In this study, we performed a meta‐analysis and a propensity score‐matched case–control study to evaluate the efficacy and safety of belimumab in patients with lupus nephritis (LN). Methods We analyzed the data from three randomized controlled trials (RCTs) to assess the effects of belimumab treatment on renal improvement and adverse effects. Our study included a total of six LN patients who received belimumab treatment and an additional six LN patients who received standard therapy. All participants were followed up for a duration exceeding 96 weeks to evaluate the outcomes of the treatments. Results Our meta‐analysis incorporated data from three articles involving a total of 666 patients. The results of the analysis revealed that a higher proportion of patients who received belimumab treatment experienced renal improvement compared to those in the control group. The patients in belimumab group had a higher renal complete response rate and proteinuria improvement rate compared to the control group. However, belimumab treatment did not increase the renal partial response rate compared to the control group. The belimumab group also exhibited a higher proportion of patients who achieved normalization of antidouble‐stranded DNA, as well as normalization of low C3 and C4 levels. In our case–control study, significant improvement in proteinuria was demonstrated with belimumab at Week 48 (p = 0.037) and at all subsequent time points (all p < 0.05). Over the course of 96 weeks, belimumab treatment was associated with renal function stabilization and an increase in C3 and C4 levels. Moreover, the use of belimumab resulted in a reduction in glucocorticoid dosage at Week 24 (p = 0.02). Additionally, patients receiving belimumab treatment had a lower risk of severe treatment‐emergent adverse events, and no other significant adverse effects were observed between the two groups. Conclusions In patients with LN, the utilization of belimumab therapy has demonstrated notable improvements in renal response rates. Additionally, it has shown a decreased likelihood of serious treatment‐related adverse events and a diminished need for glucocorticoid dosage when compared to the active control group.
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spelling doaj-art-bcff5f73979649dd9f28efb8b765573c2025-08-20T02:47:24ZengWileyImmunity, Inflammation and Disease2050-45272023-07-01117n/an/a10.1002/iid3.954Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control studyKai Zhang0Tiening Qi1Donghua Guo2Youxia Liu3Department of Nephrology Tianjin Medical University General Hospital Tianjin People's Republic of ChinaDepartment of Operating Room Tianjin Medical University General Hospital Tianjin People's Republic of ChinaDepartment of Nephrology Tianjin Medical University General Hospital Airport Hospital Tianjin People's Republic of ChinaDepartment of Nephrology Tianjin Medical University General Hospital Tianjin People's Republic of ChinaAbstract Objective In this study, we performed a meta‐analysis and a propensity score‐matched case–control study to evaluate the efficacy and safety of belimumab in patients with lupus nephritis (LN). Methods We analyzed the data from three randomized controlled trials (RCTs) to assess the effects of belimumab treatment on renal improvement and adverse effects. Our study included a total of six LN patients who received belimumab treatment and an additional six LN patients who received standard therapy. All participants were followed up for a duration exceeding 96 weeks to evaluate the outcomes of the treatments. Results Our meta‐analysis incorporated data from three articles involving a total of 666 patients. The results of the analysis revealed that a higher proportion of patients who received belimumab treatment experienced renal improvement compared to those in the control group. The patients in belimumab group had a higher renal complete response rate and proteinuria improvement rate compared to the control group. However, belimumab treatment did not increase the renal partial response rate compared to the control group. The belimumab group also exhibited a higher proportion of patients who achieved normalization of antidouble‐stranded DNA, as well as normalization of low C3 and C4 levels. In our case–control study, significant improvement in proteinuria was demonstrated with belimumab at Week 48 (p = 0.037) and at all subsequent time points (all p < 0.05). Over the course of 96 weeks, belimumab treatment was associated with renal function stabilization and an increase in C3 and C4 levels. Moreover, the use of belimumab resulted in a reduction in glucocorticoid dosage at Week 24 (p = 0.02). Additionally, patients receiving belimumab treatment had a lower risk of severe treatment‐emergent adverse events, and no other significant adverse effects were observed between the two groups. Conclusions In patients with LN, the utilization of belimumab therapy has demonstrated notable improvements in renal response rates. Additionally, it has shown a decreased likelihood of serious treatment‐related adverse events and a diminished need for glucocorticoid dosage when compared to the active control group.https://doi.org/10.1002/iid3.954a propensity score‐matched case–control studybelimumablupus nephritismeta‐analysisrandomized controlled trials
spellingShingle Kai Zhang
Tiening Qi
Donghua Guo
Youxia Liu
Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
Immunity, Inflammation and Disease
a propensity score‐matched case–control study
belimumab
lupus nephritis
meta‐analysis
randomized controlled trials
title Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
title_full Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
title_fullStr Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
title_full_unstemmed Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
title_short Efficacy and safety of belimumab therapy for patients with lupus nephritis: A meta‐analysis and a propensity score‐matched case–control study
title_sort efficacy and safety of belimumab therapy for patients with lupus nephritis a meta analysis and a propensity score matched case control study
topic a propensity score‐matched case–control study
belimumab
lupus nephritis
meta‐analysis
randomized controlled trials
url https://doi.org/10.1002/iid3.954
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