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Belimumab inhibits B-cell activating factor and is approved for the treatment of patients with systemic lupus erythematosus (SLE) and lupus nephritis, alongside standard therapy, by the U.S. Food and Drug Administration (FDA).1,2 However, the treatment can be ineffective for some patients.3 Telitacicept inhibits both B-cell activating factor and a proliferation-inducing ligand simultaneously and is approved in China for the treatment of active SLE.1,3
Below, we summarize the efficacy and safety of telitacicept in cases published by Fan et al. in Zeitschrift für Rheumatologie1 and Huang et al. in Lupus,3 where belimumab did not yield an adequate response.
For the case series by Fan et al., the records of patients diagnosed with SLE at the Wuhan Hospital of Chinese and Western Medicine, China, between March 2022 and July 2023, were assessed.
A total of 14 patients with refractory SLE were treated with telitacicept 160 mg (n = 7) and 80 mg (n = 7) after suboptimal response with belimumab plus standard therapy. The mean age was 32.9 years; 79% were female. Before telitacicept, five patients received ≥2 immunosuppressants, and all had discontinued belimumab for ≥6 months due to persistent and recurrent conditions and difficulty in tapering steroids.
Treatment with telitacicept for an average of 34.1 (17–62) weeks (observational endpoint) resulted in:
Figure 1. Reduction in A SLEDAI score, B PGA score, and C glucocorticoid use in patients receiving telitacicept after inadequate response with belimumab*
PGA, Physician Global Assessment; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index.
*Data from Fan, et al.1
Figure 2 elucidates a case report, wherein SLE, unresponsive to ten doses of belimumab, was effectively controlled following a switch to telitacicept.
Figure 2. Clinical case overview of a 35-year-old female*
ANA, anti-nuclear antibody; CT, computed tomography; dsDNA, double-stranded DNA; MMF, mycophenolate mofetil; MP, methylprednisolone; WBC, white blood cell.
*Data from Huang, et al.2
Key learnings1,3 |
Telitacicept appears to be an effective and safe alternative treatment in patients with SLE who show inadequate response to belimumab. |
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